Hypointense hepatic lesions depicted on gadobenate dimeglumine-enhanced three-hour delayed hepatobiliary-phase MR imaging: differentiation between benignancy and malignancy.
Gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging simultaneously provides both morphological and functional information by the acquisition of dynamic and hepatobiliary-phase imaging. Focal lesions with no functioning hepatocytes, where hepatobiliary metabolism is blocked or inhibited, are generally unable to uptake and excrete gadobenate dimeglumine into the bile. Such lesions are typically malignant and usually appear hypointense as compared to the normal liver parenchyma as seen on hepatobiliary-phase imaging. However, various benign hepatic lesions may also be hypointense due to (a) the presence of no functioning hepatocytes, (b) damage to the functioning hepatocytes or (c) impairment of biliary function as depicted on hepatobiliary-phase imaging. All of these imaging features may result in recognition of the benign hepatic lesions as hepatic malignancies. As depicted on three-hour delayed hepatobiliary-phase imaging, peripheral iso/hyperintensity due to fibrotic tissue compared to the hypointense center with a fuzzy margin may be a clue for the presence of a benign hepatic lesion. In contrast, peripheral hypointensity due to rich tumoral cellularity compared to the center with a clear margin may favor an indication of the presence of a malignant hepatic lesion.
Hwang
Hye Sun
HS
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, Korea.
Kim
Seong Hyun
SH
Jeon
Tae Yeon
TY
Choi
Dongil
D
Lee
Won Jae
WJ
Lim
Hyo K
HK
D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D013995:Time
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine