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Posted: April 4th, 2019
Using MRI to diagnose hepatic focal lesions
Hepatic focal lesions are abnormal growths or masses in the liver that can be benign or malignant. They can have various causes, such as infections, inflammation, trauma, vascular disorders, or tumors. Some of the common types of hepatic focal lesions are hemangiomas, focal nodular hyperplasia, hepatic adenomas, and hepatocellular carcinoma.
Magnetic resonance imaging (MRI) is a non-invasive imaging technique that uses a strong magnetic field and radio waves to produce detailed images of the internal organs and tissues. MRI can provide valuable information about the size, shape, location, and characteristics of hepatic focal lesions, as well as their relationship with the surrounding liver parenchyma and vasculature. MRI can also help differentiate benign from malignant lesions, and guide the diagnosis and treatment of hepatic focal lesions.
MRI has several advantages over other imaging modalities, such as ultrasound, computed tomography (CT), or positron emission tomography (PET), for the evaluation of hepatic focal lesions. MRI has higher spatial resolution and contrast resolution, which allows for better visualization of small and subtle lesions. MRI can also depict the signal intensity and enhancement patterns of hepatic focal lesions, which can reflect their histological features and biological behavior. MRI can also use different sequences and techniques, such as diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), spectroscopy, or elastography, to provide additional functional and metabolic information about hepatic focal lesions.
However, MRI also has some limitations and challenges for the diagnosis of hepatic focal lesions. MRI is more expensive and time-consuming than other imaging modalities, and requires a high level of expertise and experience to interpret the images. MRI is also contraindicated for patients with metallic implants or devices, such as pacemakers or cochlear implants, or patients with claustrophobia or anxiety. MRI is also sensitive to motion artifacts, which can degrade the image quality and affect the accuracy of the diagnosis. Moreover, MRI is not a definitive diagnostic tool for hepatic focal lesions, and sometimes requires further confirmation by biopsy or follow-up imaging.
Therefore, MRI is a useful and powerful imaging technique for the evaluation of hepatic focal lesions, but it should be used with caution and in conjunction with clinical and laboratory data. MRI can help identify and characterize hepatic focal lesions, but it cannot replace the histopathological examination or the clinical judgment of the physician. MRI should be performed by qualified radiologists who are familiar with the indications, protocols, and interpretation of MRI for hepatic focal lesions.
References:
– Chen JH, Chang YC, Chen TC. Magnetic resonance imaging of hepatic focal lesions: current status and future perspectives. World J Gastroenterol 2016;22(30):6854-6870.
– Grazioli L, Bondioni MP, Haradome H et al. Hepatocellular adenoma and focal nodular hyperplasia: value of gadoxetic acid-enhanced MR imaging in differential diagnosis. Radiology 2012;262(2):520-529.
– Lee MW. Magnetic resonance imaging for hepatocellular carcinoma: diagnosis using gadoxetic acid contrast agent. Clin Mol Hepatol 2019;25(1):5-14.
– Sirlin CB, Reeder SB. Magnetic resonance imaging quantification of liver iron. Magn Reson Imaging Clin N Am 2010;18(3):359-381.
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