Abstract
BackgroundDiagnosis 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.ResultsOut 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%).ConclusionCombined 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.
Highlights
Diagnosis of a small hepatic focal lesion (≤ 2 cm) in a cirrhotic liver by Magnetic resonance imaging (MRI) depending on its characteristic signal intensities at different sequences, contrast enhancement, and diffusion-weighted image (DWI)
Combined triphasic MRI and diffusion Weighted image (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
All patients in our study had biopsied except for 8 cases with hemangioma Which we depended in its final diagnosis upon follow-up by AFP and repeated MRI every 3 months
Summary
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). 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. Liver cirrhosis occurs due to an irreversible renovation of the hepatic parenchyma with fibrosis and formation of different types of hepatocellular nodules. Cirrhosis-associated hepatocellular nodules occur due to the focal area of hepatocytes and stromal proliferation in response to liver injury leading to the formation of regenerative nodules. Cirrhotic liver nodules were classified into regenerative, dysplastic, and neoplastic nodules [3]. Neoplastic nodules were divided into adenoma, dysplastic foci, dysplastic nodules, and HCC [4]
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