Liver mass MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

On MRI, characteristic features for the diagnosis of liver mass, include: higher soft tissue contrast, lack of radiation exposure, lesion characterization by evaluation of signal intensities, improving detection of hypervascular lesions, and characterization of the dynamics of contrast uptake.

MRI

On MRI, characteristic features for the diagnosis of liver mass, include:

• Higher soft tissue contrast
• Lack of radiation exposure
• Lesion characterization by evaluation of signal intensities
• Improving detection of hypervascular lesions

• Characterization of the dynamics of contrast uptake

	Ultrasound	CT scan	MRI
Hepato cellular adenoma	Heterogeneous Hyperechoic if steatotic Anechoic center if hemorrhage	Well demarcated with peripheral enhancement Homogenous more often than heterogeneous Hypodense if steatotic Hyperdense if hemorrhagic	HNF1 α: signal lost on chemical shift; moderate arterial enhancement without persistent enhancement during delayed phase IHCA: markedly hyperintense on T2 with stronger signal peripherally; persistent enhancement in delayed phase β-Catenin: inflammatory subtype has same appearance as IHCA Noninflammatory is heterogeneous with no signal dropout on chemical shift Isointense of T1 and T2 with strong arterial enhancement and delayed washout
Hemangioma	Hyperechoic with well-defined rim and with few intranodular vessels	Discontinuous peripheral nodular enhancement Isoattenuating to aorta with progressive centripetal fill-in	T1: hypointense; discontinuous peripheral enhancement with centripetal fill-in T2: hyperintense relative to spleen
FNH	Generally isoechoic	Central scar Arterial phase shows homogenous hyperdense lesion Returns to precontrast density during portal phase that is hypo or isodense	T1: isointense or slightly hypointense. Gadolinium produces early enhancement with central scar enhancement during delayed phase T2: slightly hyperintense or isointense
NRH	Isoechoic/hyperechoic	Nonenhancing nodules, sometimes hypodense, with variable sizes (most sub-centimeter)	T1: hyperintense T2: varied intensity (hypo/iso/hyperintense)