Differenzierung zwischen benignen und malignen Leberläsionen mit der Nativ-MRT

Grebe, Paul; Schild, Hans H.; Kreitner, K.-F.; Ferber, A.

doi:10.1055/s-2008-1032558

Cited by 2 publications

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The Abdomen

Kühn¹,

Lühken²

2014

Whole-Body MRI Screening

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Focal liver lesions are present in more than 5 % of the population and are often detected incidentally when an imaging study is performed for another reason. In 40 % of cases, it is not possible to categorize such incidental lesions adequately by imaging ( Strobel and Bernatik 2006 ). Liver lesions are especially challenging for the radiologist interpreting whole-body screening MRI studies, which typically only include non-contrast-enhanced pulse sequences. With unenhanced MR images, only a crude characterization of focal liver lesions is possible.In the screening situation, we can roughly distinguish three categories of focal liver lesions: benign cysts and cyst-like lesions, benign solid masses, and solid malignancies (Table 8.1 ). Lesions with a cystic appearance such as dysontogenetic cysts, echinococcal cysts, and cavernous hemangiomas can be diagnosed with confi dence on the basis of an unenhanced MRI examination (including conventional T1-and T2-weighted sequences), and treatment recommendations can be made accordingly. This is not the case for solid liver lesions such as focal nodular hyperplasia, hepatocellular adenoma, metastasis, hepatocellular carcinoma, or cholangiocellular carcinoma. In most instances, a contrast-enhanced study is necessary to characterize solid liver lesions and estimate their total extent.

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The Abdomen

Kühn¹,

Lühken²

2014

Whole-Body MRI Screening

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Contrast Agents for Hepatic Magnetic Resonance Imaging

Morana

Grazioli²,

Testoni³

et al. 2002

Topics in Magnetic Resonance Imaging

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The current availability of liver-specific contrast media (LSCM) allows the possibility to obtain an accurate diagnosis when studying focal liver lesions (FLL). It is necessary to have an in-depth knowledge of the biologic and histologic characteristics of FLL and the enhancement mechanism of LSCM to gain significant accuracy in the differential diagnosis of FLL. It is possible to subdivide FLL into three main groups according to the kinetics of contrast enhancement: hypervascular FLL, hypovascular FLL, and FLL with delayed enhancement. Dynamic contrast-enhanced magnetic resonance imaging is an important tool in the identification and characterization of FLL. LSCM with a first phase of extracellular distribution give both dynamic (morphologic) and late phase (functional) information useful for lesion characterization. With LSCM it is possible to differentiate with high accuracy benign from malignant lesions and hepatocellular from nonhepatocellular lesions. To understand contrast behavior after injection of LSCM, it is necessary to correlate contrast enhancement with the biologic and histologic findings of FLL.

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Differenzierung zwischen benignen und malignen Leberläsionen mit der Nativ-MRT

Abstract: Using these sequences and criteria it is not possible to distinguish between malignant and benign lesions of the liver with sufficient accuracy.

Cited by 2 publications

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The Abdomen

The Abdomen

Contrast Agents for Hepatic Magnetic Resonance Imaging

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