MRI Various Sequences in Evaluation of Hypervascular Hepatic Focal Lesions in Cirrhotic Patients

Abstract

epatic focal lesions may be benign or malignant and some of the hypervascular focal lesions may be benign. Therapy requires an accurate diagnosis, which in turn relies primarily on appropriate imaging and image-guided biopsy. Triphasic CT was believed to be the standard in evaluating the hepatic focal lesions and together with alpha-feto protein, the lesions were decided either non conclusive and needing biopsy or conclusive. According to number and distribution of the lesions (if proved malignant); surgery, radiofrequency ablation, alcohol injection or chemo-embolization was decided. Unfortunately, not all cases with HCC having high alpha fetoprotein and not all cases having typical imaging criteria of HCC and also, not all lesions detected by US are seen in the dynamic CT study. MRI having many sequences, markedly helps in the detection of small lesions and in reaching the diagnosis easily sometimes without contrast as in cysts and hemangiomas and sometimes with contrast injection. For hepatic focal lesions detection and characterization, conventional MRI relies on T1-weighted, T2-weighted, and dynamic gadolinium-enhanced T1-weighted imaging. DW MRI in the liver is a relative new and increasingly used imaging technique. It has the advantage that it can be