MRI possibilities in focal liver lesions diagnostics

Abstract

Background. Detection of focal liver lesions sometimes brings difficulties to radiologist in setting the origin of lesion. In most cases MRI or CT scan should be performed for differentiation benign liver lesion from malignant. In some case MRI is superior to CT, because MRI has greater temporal and spatial resolution, possibility of diffusion weighted imaging and usage different types of contrast media. Recently in some countries for clinical use was approved liver-specific contrast medium, which has mixed extracellular and hepatobiliary contrast enhancement patterns. This allows to obtain all phases of dynamic imaging and additional hepatobiliary phase. The last one is obtained when healthy hepatocytes uptake the contrast agent. Aim. Review recent articles focused in MRI diagnostics of focal liver lesions, using liver-specific contrast agents. Define the properties of liver-specific contrast agents and main characteristics of focal lesions on MRI imaging. Materials and methods. Scientific literature review, keywords for article search in database: liver-specific contrast agents, gadoxetic acid, focal liver lesions, MRI. Additional inclusion criteria – article published in recent 5 years. Results. Hepatobiliary phase is important in differentiation of such lesions like focal nodular hyperplasia and adenoma, it helps more accurately detect hepatocellular carcinoma and metastases. Liver-specific enhancement has a limitation, as it directly depends on liver function state. In patients with severe cirrhosis due to poor capture of contrast medium in liver hepatocytes quality of hepatobiliary phase images can be insufficient. Conclusions. Recent introduction of liver-specific contrast agents is additional complement that is helpful in focal liver lesion detection. Knowledge of liver focal lesion structural features and contrast agent`s behavior is important for understanding enhancement patterns. The possibility to choose contrast agent with different propertie