The role of MRI in differentiation between Hepatocellular Carcinoma and benign hyper vascular lesions in cirrhotic patients.

Abstract

With the widespread of cross-sectional imaging, a growth of incidentally detected focal liver lesions (FLL) hasbeen observed. A reliable detection and characterizationof FLL is critical for optimal patient management. Maximizing accuracy of imaging in the context ofFLL is paramount in avoiding unnecessary biopsies,which may result in post-procedural complications.Atremendous development of new imaging techniques has taken place during these last years. Nowadays,Magnetic resonance imaging (MRI) plays a key rolein management of liver lesions, using a radiation-free technique and a safe contrast agent profile. MRI playsa key role in the non-invasive correct characterizationof FLL. MRI is capable of providing comprehensive and highly accurate diagnostic information, withthe additional advantage of lack of harmful ionizingradiation. These properties make MRI the mainstay forthe noninvasive evaluation of focal liver lesions. We review the state-of-the-art MRI liver protocol,briefly discussing different sequence types, the uniquecharacteristics of imaging non-cooperative patients anddiscuss the role of different MR contrast agents.A review of the imaging features of the most commonbenign and malignant FLL is presented, supplementedby a schematic representation of a simplistic practicalapproach on MRI.

Key words:

Malignant; Benign; Magnetic resonance imaging; Focal liver lesions; MR contrastagents; Diffusion weighted imaging.