Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
On MRI, characteristic features for the diagnosis of liver mass, include: higher soft tissue contrast, lack of radiation exposure, lesion characterization by evaluation of signal intensities, improving detection of hypervascular lesions, and characterization of the dynamics of contrast uptake.[1]
MRI
On MRI, characteristic features for the diagnosis of liver mass, include:
- Higher soft tissue contrast
- Lack of radiation exposure
- Lesion characterization by evaluation of signal intensities
- Improving detection of hypervascular lesions
- Characterization of the dynamics of contrast uptake
| Disease
|
Ultrasound
|
CT scan
|
MRI
|
| Hepatocellular adenoma
|
- Heterogeneous
- Hyperechoic if steatotic
- Anechoic center if hemorrhage
|
- Well demarcated with peripheral enhancement
- Homogenous more often than heterogeneous
- Hypodense if steatotic
- Hyperdense if hemorrhagic
|
- HNF1 α: signal lost on chemical shift; moderate arterial enhancement without persistent enhancement during the delayed phase
- IHCA: markedly hyperintense on T2 with stronger signal peripherally; persistent enhancement in the delayed phase
- β-Catenin: inflammatory subtype has the same appearance as IHCA
- Noninflammatory is heterogeneous with no signal dropout on chemical shift
- Isointense of T1 and T2 with strong arterial enhancement and delayed washout
|
| Hemangioma
|
- Hyperechoic with well-defined rim and with few intranodular vessels
|
- Discontinuous peripheral nodular enhancement
- Isoattenuating to the aorta with progressive centripetal fill-in
|
- T1: Hypointense; discontinuous peripheral enhancement with centripetal fill-in
- T2: Hyperintense relative to spleen
|
| FNH
|
|
- Central scar
- Arterial phase shows homogenous hyperdense lesion
- Returns to precontrast density during the portal phase that is hypo or isodense
|
- T1: Isointense or slightly hypointense. Gadolinium produces early enhancement with central scar enhancement during the delayed phase
- T2: Slightly hyperintense or isointense
|
| NRH
|
|
- Nonenhancing nodules, sometimes hypodense, with variable sizes (most sub-centimeter)
|
- T1: hyperintense
- T2: varied intensity (hypo/iso/hyperintense)
|
| Simple hepatic cysts (SHCs)
|
- Anechoic
- Homogeneous
- Fluid filled
- Smooth margins
|
- Well-demarcated
- Water-attenuated
- Smooth lesion without an internal structure
- No enhancement with contrast
|
- T1: hypointense signal intensity
- T2: hyperintense signal intensity
|
| Biliary cystadenomas (BCs)
|
- Irregular walls
- Internal septations forming loculi
|
- Heterogeneous
- Internal septations
- Irregular papillary growths
- Thickened cyst walls
|
- T1: Hypointense signal intensity
- T2: Hyperintense signal intensity
|
| Hydatid cysts (HCs)
|
- May appear similar to SHC.
- Progress to develop
- Thick calcified walls
- Hyperechoic/hypoechoic contents.
- Daughter cysts in the periphery
|
- Hypodense lesion with hypervascular pericyst wall
- Distinct endocyst wall
- Calcified walls and septa
- Daughter cysts within the periphery of the mother cyst
|
- T1: Hypointense signal intensity of cyst contents
- T2: Hyperintense signal intensity of cyst contents
- Hypointense rim on T2
- Daughter cysts within the periphery of the mother cyst
- Collapse parasitic membranes as floating linear structures within cyst
|
References