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
Ultrasound
CT scan
MRI
Hepato cellular 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 delayed phase
IHCA: markedly hyperintense on T2 with stronger signal peripherally; persistent enhancement in delayed phase
β-Catenin: inflammatory subtype has 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 aorta with progressive centripetal fill-in
T1: hypointense; discontinuous peripheral enhancement with centripetal fill-in
T2: hyperintense relative to spleen
FNH
Generally isoechoic
Central scar
Arterial phase shows homogenous hyperdense lesion
Returns to precontrast density during portal phase that is hypo or isodense
T1: isointense or slightly hypointense. Gadolinium produces early enhancement with central scar enhancement during delayed phase
T2: slightly hyperintense or isointense
NRH
Isoechoic/hyperechoic
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 periphery.
Hypodense lesion with hypervascular pericyst wall
Distinct endocyst wall
Calcified walls and septa easily detected.
Daughter cysts seen peripherally within mother cyst.
T1: Hypointense signal intensity of cyst contents.
T2: Hyperintense signal intensity of cyst contents.
Hypointense rim on T2.
Daughter cysts seen peripherally within mother cyst.
Collapse parasitic membranes seen as floating linear structures within cyst.
