The role of MDCT and MRI in the diagnosis of focal liver diseases

Abstract

Despite the great technical achievements in the field of tomographic examinations (CT, MRI), the problem of differentiation of focal liver lesions cannot always be solved only in a non-invasive way. At the same time, MRI with a hepatospecific agent, gadoxetic acid, can solve many problems, primarily related to the diagnosis of liver metastases and monitoring of nodules in cirrhotic liver. The aim. To show the advantages of MRI with hepatobiliary MRI contrast agents as the final phase of non-invasive diagnosis of focal liver lesions. Material and methods . Abstracts of 183 scientific articles (2010–2019) were selected in the PubMed information and analytical system for the keywords “focal liver lesion” and “gadoxetic acid”. Articles about special aspects of MRI examination or general information were excluded. 29 full-text articles were selected for analysis. Results . The analysis data are grouped in three categories as “diagnosis of liver metastases”, “diagnosis of HCC against the background of normal hepatic parenchyma”, “MRI diagnosis of HCC against the background of cirrhosis”. Conclusion. The main achievement of MRI diagnostics with gadoxetic acid is the differentiation of small focal liver lesions, including metastases, regenerative nodes, dysplastic nodes, and highly differentiated HCC. This allows you to increasingly avoid invasive methods in the diagnosis of focal liver lesions. Integrated MRI technologies (MRI-DVI and MRI with gadoxetic acid) are currently the most informative, safe and in demand. In MRI with hepatobiliary contrast agents, the intensity of the HCC signal in the hepatospecific phase is considered as an imaging tumor biomarker. Border small liver nodules are usually not hypervascular, they are hypointensive in the hepatospecific phase.