High signal liver focal lesions on DWI: the differential diagnostic value of morphological characteristics and ADC value



To explore the value of DWI morphological characteristics and ADC value in differentiating malignant and benign lesions of the liver at 3.0 T.

Materials and methods

In this study, 310 patients with the same number of liver lesions confirmed by histopathology with high signal on DWI were collected. For each lesion, two radiologists independently measured the ADC values and evaluated the DWI morphological characteristics. The differences of the quantitative and qualitative MRI features determined by the readers were assessed. The ADC values of the malignant and benign liver lesions were compared. Besides, Chi-square tests were used to compare the proportion of differences in the DWI morphological characteristics between malignant and benign liver lesions. ROC curve was used to evaluate the diagnostic efficacy of ADC value and DWI morphological features.


No significant differences were observed in the quantitative and qualitative MRI features determined by the readers. The ADC values for malignant liver lesions were lower than those for benign lesions (statistically significant, P < 0.05). There was significant difference in the proportion of DWI morphological features between benign and malignant liver lesions. The proportion of morphological characteristics of ring and nodular high signal intensity was higher in malignant liver lesions. In benign lesions, the proportion of flaky and homogeneous high signal morphological features was higher. The AUC of DWI morphological features + ADC value was significantly higher than those of ADC value or DWI morphological features (P = 0.0277, P < 0.0001).


The combined application of DWI morphological features and ADC value is the most valuable in differentiating malignant and benign liver lesions.

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This study was supported by National Natural Science Foundation of China (No. 81771785). The funders had no role in research design, data collection and analysis, decision to publish or preparation of the manuscript.

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Correspondence to Huiyi Ye.

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Zhang, H., Sheng, F., Pan, J. et al. High signal liver focal lesions on DWI: the differential diagnostic value of morphological characteristics and ADC value. Chin J Acad Radiol (2021). https://doi.org/10.1007/s42058-021-00052-8

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  • Liver lesion
  • Diffusion-weighted imaging
  • DWI
  • Magnetic resonance imaging
  • MRI
  • Morphological characteristics