D. Inoue, Kanazawa, JP

To elucidate the signal intensity pattern of hepatic pseudolesion observed in the third inflow area on hepatobiliary phase (HBP) of Gd-EOB-DTPA enhanced MRI (EOB-MRI).

Material and methods

Total 215 hepatic pseudolesions in the third inflow area, which were incidentally diagnosed by CT during arterial portography (CTAP) for closer examination of liver lesion, were subjected to this study. The location, background liver condition, and HBP signal intensity pattern of the hepatic pseudolesion observed in the third inflow area were investigated. Chi-square test were used for statistical analysis and p<0.05 were regarded as significant.

Results

Within 215 pseudolesions, 9.3% (n=20) showed signal intensity difference compared with background liver parenchyma on HBP of EOB- MRI. Detailed signal intensity pattern were as follows: 6.5% (n=14) showed hyper-intensity, and 2.8% (n=6) showed hypo-intensity on HBP of EOB-MRI. Location of the lesions were as follows: posterior aspect of segment 4; n=15, hepatic parenchyma surrounding gallbladder fossa; n=6. There was no significant difference (p=0.08) in incidence of signal intensity difference of pseudolesion on HBP images between liver disease cases (n=188) and normal liver cases (n=27). 85.7% of hyper-intensity pseudolesion showed hyper-intensity on T1- and hypo-intensity on T2-weighted image. In contrast, 83.3% hypo-intensity pseudolesion showed iso-intensity both on T1- and T2-weighted image.

Conclusion

About 9% of the hepatic pseudolesion observed in the third inflow area show signal intensity difference compared to the background liver parenchyma on HBP of EOB-MRI. In particular, 2.8% of the pseudolesion show hypo-intensity on HBP and it should be distinguished from true liver tumor.

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