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Radiology, Vol 179, 675-679, Copyright © 1991 by Radiological Society of North America

ARTICLES

Focal hepatic lesions: differentiation with MR imaging at 0.5 T

JJ Brown, JM Lee, JK Lee, KJ Van Lom and SC Malchow
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.

Magnetic resonance (MR) examinations of 43 patients with 95 focal hepatic lesions (diameter, greater than 1 cm) were analyzed for lesion shape, homogeneity, and relative signal intensity compared with normal liver parenchyma, spleen, and skeletal muscle. On T1-weighted, balanced, and T2-weighted images, most metastases (74%), cavernous hemangiomas (76%), and cysts (82%) were smooth and round or oval, while the hepatocellular carcinomas all had irregular borders (40%) or were lobulated (60%). All lesions with irregular borders were malignant. Seventy percent of metastatic lesions, 85% of cavernous hemangiomas, and 100% of simple hepatic cysts were of homogeneous signal intensity, while 60% of hepatocellular carcinomas were inhomogeneous. Logistic regression analysis of multiple lesion characteristics showed that inhomogeneous lesions had a high likelihood of malignancy, while markedly hyperintense lesions had a very low probability of being malignant, regardless of other traits. Homogeneous lesions that were isointense or hyperintense compared with spleen on balanced images but were not markedly hyperintense on T2-weighted images also had a high likelihood of malignancy.


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