title: Differentiating focal eosinophilic liver disease from hepatic metastases using unenhanced and gadoxetic acid-enhanced MRI.
abstract: OBJECTIVE
  To examine the differential features of focal eosinophilic liver disease (FELD) from liver metastases on gadoxetic acid-enhanced MRI.
  
  
  METHODS
  Twenty patients with 41 FELD and 20 patients with 55 metastases were enrolled in this study. Liver MRI consisted of precontrast 2D T1-weighted image (T1WI) and gadoxetic acid-enhanced 3D T1WI (arterial, portal, 20 min hepatocyte-selective phases), and a postcontrast T2WI. Images were analyzed for the margin and shape of the lesions; lesion conspicuity on T1- and T2WI; signal intensity of the lesions on 3D T1WI; presence of rim enhancement and misty signs; and presence of significant smaller lesions on the unenhanced T1WI (<50%) compared to hepatocyte phase image.
  
  
  RESULTS
  Univariate analysis revealed the following significant parameters to favor FELD: a fuzzy margin, irregular shape, subtle signal intensity changes on T1- and T2WI, absence of target signs on the hepatocyte phase image, presence of misty signs, and size discrepancies on T1WI and hepatocyte phase images. Multivariate analysis revealed only a significantly smaller lesion size on T1WI compared to hepatocyte phase images to be predictive of FELD.
  
  
  CONCLUSIONS
  A significantly smaller lesion size on T1WI relative to hepatocyte phase image is the best predictor for identifying FELD on gadoxetic acid-enhanced MRI.
authors: Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. jmyr@dreamwiz.com
authors: Young Kon
authors: YK
authors: Kim
authors: Young Hwan
authors: YH
authors: Lee
authors: Chong Soo
authors: CS
authors: Kim
authors: Min Woo
authors: MW
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D003287:Contrast Media; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000175:diagnosis*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA