Abstract

Purpose: To determine the role of diffusion weighted MR imaging and apparent diffusion coefficient (ADC) in benign hepatic focal lesions. Method and Materials: This study included 47 patients (29 M, 18 F with mean age of 43 years) with benign hepatic focal lesions. They were cyst (n = 8), hemangioma (n = 23), abscess (n = 5), adenoma (n = 5), focal nodular hyperplasia (n = 4) and nodular regenerative hyperplasia (n = 2). They underwent routine MR imaging and diffusion MR weighted imaging using 1.5 tesla MR unit (Symphony-Siemens). Diffusion MR imaging was done using spin echo type of single shot echo planar imaging (EPI) with b value of 0, 500 & 1000 sec/mm2. The apparent diffusion coefficient (ADC) map was reconstructed and ADC value was measured. The mean ADC values correlated with histo-pathological results as well as follow-up imaging results. Results: Adequate ADC maps were obtained in 47 patients. The mean ADC values were 3.4 ± 0.12 × 10-3 mm2/sec in cystic lesion, 2.23 ± 0.08 × 10-3 mm2/sec in hemangioma, 1.94 ± 0.05 × 10-3 mm2/sec in abscess, 1.72 ± 0.07 × 10-3 in focal nodular hyperplasia, 1.65 ± 0.06 × 10-3 mm2/sec in adenoma, 1.62 ± 0.07 × 10-3 mm2/sec in nodular regenerative hyperplasia. The mean ADC values were significantly different within benign hepatic focal lesions (P < 0.001). The differences between the mean ADC values of FNH, adenoma and NRH were not statistically significant (P < 0.23). Conclusion: Diffusion weighted MR imaging is a new imaging modality for diagnosis and characterization of different benign hepatic focal lesions, particularly in patient with renal dysfunction.

Highlights

  • Diffusion-weighted (DW) MR imaging can be applied to liver imaging with improved image quality

  • The purpose of this study was to determine the role of diffusion weighted MR imaging and apparent diffusion coefficient (ADC) in benign hepatic focal lesions

  • The mean ADC values were significantly different within benign hepatic focal lesions (P < 0.001)

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Summary

Introduction

Diffusion-weighted (DW) MR imaging can be applied to liver imaging with improved image quality. DW MR imaging enables qualitative and quantitative assessment of tissue diffusivity (apparent diffusion coefficient) without the use of gadolinium chelates, in patients with severe renal dysfunction at risk for nephrogenic systemic fibrosis [1]. Recent advances enable the technique to be widely applied for tumor evaluation in the abdomen and pelvis and have led to the development of whole-body DWI [2]. DWI is a simple and sensitive method for screening focal hepatic lesions and is useful for differential diagnosis [2]-[4]. The purpose of this study was to determine the role of diffusion weighted MR imaging and apparent diffusion coefficient (ADC) in benign hepatic focal lesions

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