Focal hepatic lesions: differentiation with MR imaging at 0.5 T.
Magnetic resonance (MR) examinations of 43 patients with 95 focal hepatic lesions (diameter, greater than 1 cm) were analyzed for lesion shape, homogeneity, and relative signal intensity compared with normal liver parenchyma, spleen, and skeletal muscle. On T1-weighted, balanced, and T2-weighted images, most metastases (74%), cavernous hemangiomas (76%), and cysts (82%) were smooth and round or oval, while the hepatocellular carcinomas all had irregular borders (40%) or were lobulated (60%). All lesions with irregular borders were malignant. Seventy percent of metastatic lesions, 85% of cavernous hemangiomas, and 100% of simple hepatic cysts were of homogeneous signal intensity, while 60% of hepatocellular carcinomas were inhomogeneous. Logistic regression analysis of multiple lesion characteristics showed that inhomogeneous lesions had a high likelihood of malignancy, while markedly hyperintense lesions had a very low probability of being malignant, regardless of other traits. Homogeneous lesions that were isointense or hyperintense compared with spleen on balanced images but were not markedly hyperintense on T2-weighted images also had a high likelihood of malignancy.
Brown
J J
JJ
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
Lee
J M
JM
Lee
J K
JK
Van Lom
K J
KJ
Malchow
S C
SC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis