MR imaging characteristics of hepatic tumors

Martí‐Bonmatí, Luis

doi:10.1007/s003300050146

Cited by 21 publications

(12 citation statements)

References 47 publications

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“…For imaging diagnosis, focal liver lesion classification was done on the basis of the tumor-specific vascularity pattern in the arterial, portal, and late phases as described previously. [18][19][20][21][22][23][24][25] Histologic analysis (on biopsies or surgical specimens) was made when the imaging pattern was not typical or when the tumor was resected.…”

Section: Patientsmentioning

confidence: 99%

Evaluation of Liver Tumors Using Acoustic Radiation Force Impulse Elastography and Correlation With Histologic Data

Frulio

Laumonier

Carteret

et al. 2013

Journal of Ultrasound in Medicine

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Objectives Acoustic radiation force impulse (ARFI) technology represents an innovative method for the quantification of tissue elasticity. The aims of this study were to evaluate elasticity by ARFI in both liver tumors and background liver tissue and to compare ARFI measurements with histologic data in liver tumors and background liver. Methods Seventy‐nine tumors were prospectively studied: 43 benign and 36 malignant. Acoustic radiation force impulse measurements for each tumor type were expressed as mean ± standard deviation for both liver tumors and background liver; ARFI data were also correlated with histologic data. Results For liver tumors, the mean stiffness values were 1.90 ± 0.86 m/s for hepatocellular adenoma (n = 9), 2.14 ± 0.49 m/s for hemangioma (n = 15), 3.14 ± 0.63 m/s for focal nodular hyperplasia (n = 19), 2.4 ± 1.01 m/s for hepatocellular carcinoma (n = 24), and 3.0 ± 1.36 m/s for metastasis (n = 12). Important variations were observed within each tumor type or within a single tumor. These variations could have been due to necrosis, hemorrhage, or colloid. There was no statistically significant difference between the benign and malignant groups. Regarding background liver, it was possible to observe pathologic abnormalities in histologic analyses or liver function tests to explain the ARFI data. The degree of fibrosis was not the only determinant of liver stiffness in background liver; other factors such as portal embolization, sinusoidal obstruction syndrome caused by chemotherapy, and cholestasis, also could have interfered. Conclusions Acoustic radiation force impulse elastography could not allow differentiation between benign and malignant tumors. This study provides a better understanding of the correlation between ARFI and histologic data for both tumors and background liver.

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Section: Patientsmentioning

confidence: 99%

Evaluation of Liver Tumors Using Acoustic Radiation Force Impulse Elastography and Correlation With Histologic Data

Frulio

Laumonier

Carteret

et al. 2013

Journal of Ultrasound in Medicine

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“…For all three hepatobiliary contrast agents, liver-specific uptake in malignant HCCs with depiction as hyperintense lesions in the liver-specific phase has been demonstrated, but usually the frequency of this finding is low ( ! 5%) and confined to well-differentiated HCCs [52,57,64,65] . Generally, the presence of typical changes of the vascular supply will help to correctly characterize these lesions.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Imaging of Hepatocellular Carcinoma by Computed Tomography and Magnetic Resonance Imaging: State of the Art

Zech

Reiser

Herrmann³

2009

Dig Dis

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Hepatocellular carcinoma (HCC) is a very frequent tumor worldwide. Its incidence is linked to the distribution of liver cirrhosis and viral hepatitis, which are the main risk factors for the development of HCC. For the evaluation of the cirrhotic liver and for the diagnosis of HCC, multidetector computed tomography (MDCT) proved to be a robust and reliable tool. In MDCT the diagnosis of HCC can be made based on neovascularization with increased arterial and decreased portal venous supply. With modern magnetic resonance imaging (MRI), spatial resolution and robustness increased dramatically. Beside the evaluation of neovascularization by means of gadolinium-enhanced early dynamic MRI, the main advantages of MRI are additional information on tissue composition and liver-specific function. With diffusion-weighted imaging or plain T₁- and T₂-weighted sequences, different tissue elements like fat, hemorrhage, glycogen, edema and cellular density can be evaluated. Liver-specific contrast agents give insight into the Kupffer cell density or the hepatocellular function. The integration of all these parts into the MR examination allows for a very high detection rate for overt HCC nowadays, although very small HCCs are still a challenge. Moreover, insight into the different stages of hepatocarcinogenesis can be possible with MRI. Despite its limited availability in some countries, it has to be rendered to be the modality of choice for the distinct evaluation of the cirrhotic liver.

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“…It should be noted that using longer echo times causes artifactual enlargement of the iron-containing lesions, the so called "blooming effect" (7). Regenerative siderotic nodules in liver cirrhosis appear hypointense on T2-weighted images, owing to accumulation of intracellular iron (8,9) (Fig 8). Iron may also explain the hypointensity of dysplastic nodules on T2-weighted images when compared with adjacent liver parenchyma, but other causes should be considered, such as the presence of copper (10) (Fig 9).…”

Section: Iron Depositionmentioning

confidence: 99%

“…Necrotic areas may exhibit variable features on MR images, since liquefactive necrosis is highly hyperintense on T2-weighted images, owing to increased water content, whereas coagulative (dehydrated) necrosis is characterized by low SI on T2-weighted images (9). This explains the T2-weighted appearance of necrosis seen in some focal liver lesions, especially those resulting from percutaneous ablative therapies such as radiofrequency ablation (Fig 21) (9,35,36).…”

Section: Necrosismentioning

confidence: 99%

The Hypointense Liver Lesion on T2-Weighted MR Images and What It Means

Curvo-Semedo¹,

Brito²,

Seco³

et al. 2010

RadioGraphics

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).Abbreviations FNH = focal nodular hyperplasia, FSE = fast spin echo, HCC = hepatocellular carcinoma, SI = signal intensity. ABSTRACTThe vast majority of focal liver lesions are hyperintense on T2-weighted magnetic resonance (MR) images. Rarely, however, hepatic nodules may appear totally or partially hypointense on those images. Causes for this uncommon appearance include deposition of iron, calcium, or copper and are related to the presence of blood degradation products, macromolecules, coagulative necrosis, and other conditions. Although rare, low signal intensity relative to surrounding liver on T2-weighted images may be seen in a wide spectrum of lesions. Examples include cases of focal nodular hyperplasia, hepatocellular adenoma, hepatocellular carcinoma, metastases, leyomioma, siderotic or dysplastic nodules, nodules in Wilson disease, granuloma, and hydatid cyst. On fat-suppressed T2-weighted images, nodules with a lipomatous component, such as lipoma, angiomyolipoma, hepatocellular adenoma, and hepatocellular carcinoma may also appear partially or totally hypointense. The conjunction of other MR imaging findings and their integration in the clinical setting may allow a correct diagnosis in a considerable proportion of cases. The cause for T2-weighted hypointensity may not be, however, always recognized, and only pathologic correlation may provide the answer. The aims of this work are to discuss the causes and mechanisms of hypointensity of liver lesions on T2-weighted images and proposing an algorithm for classification that may be useful as a quick reminder for the interested reader. INTRODUCTIONMagnetic resonance (MR) imaging of liver lesions is of pivotal importance in clinical practice. In abdominal MR imaging, T1-and T2-weighted sequences remain a basic requirement for lesion characterization. MR signal intensity (SI) of focal liver lesions is affected by numerous pathologic factors. Histologic features strongly affect T1 and T2 relaxation times and MR imaging is unique in its ability to explore intracellular content and recognize the presence of substances that may govern signal behavior. Owing to their high cellular water content, the majority of focal liver lesions appear hyperintense on T2-weighted images. In contrast to this most frequently seen MR imaging pattern, liver nodules may show total or partial hypointensity on T2-weighted images. The hypointense appearance can be classified as absolute or relative, depending on the native SI of adjacent liver parenchyma and sequence parameters (Fig 1). Although relative hypointensity depends on the native SI of liver, which can be modified by several circumstances (eg, inflammation, diffuse iron deposition, etc), it may be more commonly encountered when

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MR imaging characteristics of hepatic tumors

Cited by 21 publications

References 47 publications

Evaluation of Liver Tumors Using Acoustic Radiation Force Impulse Elastography and Correlation With Histologic Data

Evaluation of Liver Tumors Using Acoustic Radiation Force Impulse Elastography and Correlation With Histologic Data

Imaging of Hepatocellular Carcinoma by Computed Tomography and Magnetic Resonance Imaging: State of the Art

The Hypointense Liver Lesion on T2-Weighted MR Images and What It Means

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