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Contrast Enhanced MR imaging of Liver

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Liver Diseases

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Abstract

Contrast enhanced dynamic MRI is one of the best noninvasive imaging modalities in diagnosis of liver lesions. Recent progress of the MR scanner, software techniques and new contrast agents have increased the effectiveness and accuracy in detecting and characterizing liver disease, especially focal hepatic lesions.

Currently, the extracellular contrast agent Gd-DTPA and the combined agent Gd-EOB-DTPA are the most frequently used contrast media in clinical practice. The diagnosis of hepatocellular carcinoma could be established by the typical arterial enhancement and washout phenomenon in the venous/delayed phases. Furthermore, Gd-EOB-DTPA provides quantitative functional information, help in staging liver fibrosis and provide additional tumor information in hepatobiliary images. Therefore, the contrast enhanced MR is widely used in the diagnosis of diffuse liver disease and focal hepatic lesions. However, future studies are still needed to continuously improve the diagnostic accuracy.

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Author information

Author notes

  1. Ran-Chou Chen and Chen-Te Chou contributed equally to this work.

Authors and Affiliations

  1. Commissioner, Department of Health, New Taipei City Government, New Taipei City, Taiwan

    Ran-Chou Chen

  2. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan

    Ran-Chou Chen & Chen-Te Chou

  3. Department of Radiology, Changhua Christian Hospital, Changhua City, Taiwan

    Chen-Te Chou

  4. School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chen-Te Chou

  5. Department of Molecular Biotechnology, College of Biotechnology and Bioresources, Dayeh University, Changhua City, Taiwan

    Chen-Te Chou

  6. Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan

    Yung-Liang Wan

  7. Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan

    Yung-Liang Wan

Authors
  1. Ran-Chou Chen
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  2. Chen-Te Chou
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  3. Yung-Liang Wan
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Editor information

Editors and Affiliations

  1. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Florentina Radu-Ionita

  2. New Jersey Medical School, Rutgers University New Jersey Medical School, Newark, NJ, USA

    Nikolaos T. Pyrsopoulos

  3. Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Mariana Jinga

  4. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Ion C. Tintoiu

  5. Medical Radiation Sciences, Curtin University, Perth, WA, Australia

    Zhonghua Sun

  6. “Prof. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Bucharest, Romania

    Ecaterina Bontas

Self Study

Self Study

1.1 Questions

  1. 1.

    Which of the following are true for the Gd-DTPA enhanced MR images of liver lesions with typical presentations?

    1. (a)

      Hepatic hemangioma showed peripheral nodular enhancement in arterial phase and centripetal fill-in and persistent enhancement on delayed images.

    2. (b)

      HCC features arterial enhancement and washout phenomenon on venous and/or delayed phases.

    3. (c)

      FNH is hypovascular in arterial and portal venous phases.

    4. (d)

      ICC showed no enhancement in all the dynamic phases.

  2. 2.

    Which of the followings are true for the Gd-EOB-DTPA enhanced MR images of liver lesions?

    1. (a)

      Most HCCs are hyperintense on hepatobiliary phase.

    2. (b)

      The enhancement patterns in dynamic phases are similar to Gd-DTPA.

    3. (c)

      A typical FNH is hyperintense/isointense to adjacent liver parenchyma on hepatobiliary phase imaging with a hypointense central scar.

    4. (d)

      Metastatic tumors showed hyperintense to adjacent liver parenchyma on hepatobiliary phase imaging.

1.2 Answers to the Questions

  1. 1.

    Which of the following are true for the Gd-DTPA enhanced MR images of liver lesions with typical presentations?

    • (a), (b) Correct.

    • (c) FNH showed dense arterial enhancement, rapidly returned to isointensity in venous phase, and occasionally showed delayed enhancement of its central scar.

    • (d) Most ICC showed peripheral enhancement in arterial phase, progressive concentric filling, and contrast pooling on delayed images.

  2. 2.

    Which of the followings are true for the Gd-EOB-DTPA enhanced MR images of liver lesions?

    • (a) Most HCC showed hypointense on hepatobiliary phase.

    • (b), (c) Correct.

    • (d) Most metastatic tumors showed hypointensity on hepatobiliary phase.

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Chen, RC., Chou, CT., Wan, YL. (2020). Contrast Enhanced MR imaging of Liver. In: Radu-Ionita, F., Pyrsopoulos, N., Jinga, M., Tintoiu, I., Sun, Z., Bontas, E. (eds) Liver Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-24432-3_47

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  • DOI: https://doi.org/10.1007/978-3-030-24432-3_47

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24431-6

  • Online ISBN: 978-3-030-24432-3

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