Role of Advanced Magnetic Resonance Imaging Techniques In Characterization of Hepatic Nodules In Liver Cirrhosis

Abstract

Background: Liver cirrhosis is characterized by irreversible remodeling of the hepatic architecture with bridging fibrosis and a spectrum of hepatocellular nodules which progress from regenerative nodules to low- and high-grade dysplastic nodules, followed by small and large hepatocellular carcinomas. The differentiation of these lesions is important and early detection of HCC is necessary for more effective planning of management strategies like tumor resection, liver transplantation, tumor ablation and chemo-embolization. Biopsy of all lesions detected in cirrhotic livers is neither feasible nor advisable. As an alternative, magnetic resonance imaging (MRI) represents an extremely useful method of detection and characterization of regenerating nodules, dysplastic nodules and HCC.

Aim of the work: Is to evaluate the role of advanced MRI technique including diffusion weighted images (DWIs) n diagnosis of HCC.

Patients and Methods: 37 patients, 22 male and 15 female were included in this study, all the patients suffer from HCV induced liver cirrhosis and hepatocellular carcinoma. DWIs were done on magnet (1.5 Tesla).

Results: We found that 73.6% of the HCC lesions showed diffusion restriction and 26.4% of the lesions were isointense to the liver with DWIs showing 72 % sensitivity, 78 % specificity, 76 % PPV and & 74% NPV in diagnosis of HCC.

Conclusion: DWIs and ADC maps can be used in the characterization of hepatic focal lesions but not alone and should be used in conjugation with conventional and dynamic contrast study for better characterization.