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Focal Hepatic Lesions: Diagnostic Value of Enhancement Pattern Approach with Contrast-enhanced 3D Gradient-Echo MR Imaging¹

¹ From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110. Presented as an education exhibit at the 2003 RSNA Annual Meeting. Received September 8, 2004; revision requested September 30; final revision received February 22, 2005; accepted March 1. J.J.B. is a consultant to GE Healthcare and Tyco/Mallinckrodt; all remaining authors have no financial relationships to disclose. Address correspondence to K.M.E. (e-mail: elsayesk{at}mir.wustl.edu).

Focal hepatic lesions constitute a daily challenge in the clinical setting. However, noninvasive methods can be useful in the detection and characterization of these lesions. The noninvasive diagnosis of liver lesions is usually achieved with contrast material–enhanced computed tomography and magnetic resonance (MR) imaging. Dynamic three-dimensional gradient-recalled-echo MR imaging provides dynamic contrast-enhanced thin-section images with fat saturation and a high signal-to-noise ratio and is excellent for the evaluation of various focal hepatic lesions. A comprehensive MR imaging examination in this setting includes T2-weighted and chemical shift T1-weighted imaging and demonstrates characteristic enhancement patterns that can be helpful in the diagnosis of most of these lesions. These enhancement patterns are seen during particular phases of contrast-enhanced imaging and include arterial phase enhancement, delayed phase enhancement, peripheral washout, ring enhancement, nodule-within-a-nodule enhancement, true central scar, pseudocentral scar, and pseudocapsule. Familiarity with these enhancement patterns can help in the identification of specific focal lesions of the liver.

© RSNA, 2005

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