A small hepatic nodule ( ≤2 cm) in cirrhotic liver: doTriphasic MRI and Diffusion-weighted image help in diagnosis

Abstract

Background: Diagnosis of a small hepatic focal lesion (≤ 2 cm) in a cirrhotic liver by MRI depending on its characteristic signal intensities at different sequences, contrast enhancement, and diffusion-weighted image (DWI). Liver nodules were divided into malignant or benign according to the combination of different imaging features such as contrast uptake pattern, presence of fat, necrosis, diffusion pattern, and ADC value. We study about hepatic nodules which are difficult to diagnose using triphasic CT study due to a small size which make a characteristic pattern of enhancement of these focal lesions confusing and inadequate. Triphasic MRI and DWI increase the accuracy of the diagnosis of small nodule ≤ 2 cm and help in better treatment and intervention. The purpose of the study is to clarify the role of triphasic MRI and diffusion in differentiating a small hepatic nodule less than 2 cm in cirrhotic liver. Results: Out of 60 patients with 124 hepatic nodules, MRI findings revealed 40 cases with malignant nodules (66.7%), 12 cases with premalignant nodules (20%), and 8 cases with benign nodules (hemangioma) (13.3%). Conclusion: Combined triphasic MRI and diffusion WI increase the accuracy of the diagnosis of small hepatic focal lesions in the cirrhotic liver which may be difficult to diagnose by other imaging modalities, and help in early management and intervention.