Discrimination of benign from malignant hepatic lesions based on their T2-relaxation times calculated from moderately T2-weighted turbo SE sequence

Cieszanowski, Andrzej; Szeszkowski, Wojciech; Gołębiowski, Marek; Bielecki, Dennis K.; Grodzicki, Mariusz; Pruszyński, B

doi:10.1007/s00330-002-1366-6

Cited by 44 publications

(38 citation statements)

References 21 publications

(56 reference statements)

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“…d MRI features of a giant cavernous haemangioma; the tumour is heterogeneous, displaying internal septations, lobulated contours and a CSFlike signal intensity on this FSE T2-w image similar to cerebrospinal fluid (CSF), due to the long T2 relaxation time of its blood-filled vascular channels, a feature that has been coined as the bulb-light sign [5][6][7]10]. In the past, calculation of the T2 relaxation time was deemed useful for its differential diagnosis with other focal liver lesions, since a relaxation value of at least 112 ms could differentiate it from metastases with a 92-97% accuracy [5,6,12,[14][15][16]. Other MRI approaches may include a double-echo heavily T2-w sequence [17,18], a fluid-attenuated inversion recovery (FLAIR) or the use of the balanced steady-state free precession (SSFP) sequence [19,20], which can discriminate between haemangiomas and simple liver cysts without the need for contrast injection (Fig.…”

Section: Common Imaging Findingsmentioning

confidence: 99%

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

et al. 2007

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Haemangiomas are common focal liver lesions, generally detected in the work-up of asymptomatic patients. From the pathological point of view, they can be classified as small (capillary) or large, with cavernous vascular spaces that may show thrombosis, calcifications and hyalinisation. The polymorphic imaging appearance of haemangiomas depends on their histological features and flow pattern. The widespread use of cross-sectional imaging has allowed an increased detection rate and a better characterisation of this benign tumour. Recent developments of ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) providing high spatial and temporal resolution, together with the use of new contrast agents and/or pulse sequences has broadened the spectrum of imaging findings, contributing to diagnostic refinement in difficult cases. The scope of the present article is to provide an overview of the range of appearances of haemangiomas, explored with recent crosssectional imaging modalities, emphasising its atypical findings as explored by temporally resolved contrast-enhanced imaging.

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Section: Common Imaging Findingsmentioning

confidence: 99%

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

et al. 2007

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“…MRI has been frequently utilized for detecting and characterizing hepatic nodules among other applications in the evaluation of abdominal diseases (1) . In this context, hepatic nodules are most frequently found, the benign ones corresponding to simple cysts present in 2%-7% of the general population, and hemangiomas present in up to 20% of cases of autopsy (2,8) .…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) has been frequently utilized for detecting and characterizing hepatic nodules, among other applications in the evaluation of abdominal diseases (1) . Hepatic nodules are frequently found on abdominal MRI stud-ies and must be characterized.…”

Section: Introductionmentioning

confidence: 99%

“…Because of the similarity between the signals of these lesions, intravenous paramagnetic contrast (gadolinium) injection is required for differentiation between cysts and hemangiomas (1,4) . Despite the safety and low toxicity of the gadolinium-based paramagnetic contrast agents, especially as compared with iodinated contrast agents, the utilization of this type of contrast agent increases the cost of the study.…”

Section: Introductionmentioning

confidence: 99%

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Diferenciação entre cisto simples e hemangioma hepático utilizando seqüência de ressonância magnética ponderada em T2 com técnica gradiente-eco (B-FFE)

et al. 2008

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OBJECTIVE: To establish the role of MRI T2-weighted sequences in the differentiation between simple cysts and hepatic hemangiomas. MATERIALS AND METHODS: A double-blinded, prospective, observational, crosssectional study evaluated 52 patients with 91 hepatic lesions (34 simple cysts and 57 hemangiomas) submitted to abdominal magnetic resonance imaging. The combined analysis of all sequences was considered as the golden-standard. TSE sequences with long echo trains and b-FFE sequences were subjectively analyzed by two independent observers for differentiating cysts from hemangiomas. The kappa test (κ κ κ κ κ) was utilized in the analysis of the methods accuracy and inter-and intra-observer agreement ( p < 0.05*). RESULTS: Cysts and hemangiomas dimensions ranged respectively between 0.5 and 6.5 cm (mean = 1.89 cm), and 0. OBJETIVO: Estabelecer o valor das seqüências ponderadas em T2 para diferenciar cistos simples de hemangiomas hepáticos. MATERIAIS E MÉTODOS: Estudo prospectivo, observacional, transversal e duplo-cego em 52 pacientes com 91 lesões hepáticas (34 cistos simples e 57 hemangiomas) submetidos a ressonância magnética de abdome. A análise conjunta de todas as seqüências realizadas foi considerada o padrão-ouro. Dois observadores independentes avaliaram, subjetivamente, as seqüências TSE com TE longo e B-FFE, procurando diferenciar cistos de hemangiomas. Foram calculadas a eficácia das seqüências e a concordân-cia interobservador e intra-observador por meio do teste kappa (κ κ κ κ κ) (p < 0,05*). RESULTADOS: As dimensões dos cistos variaram entre 0,5 e 6,5 cm (média de 1,89 cm) e as dos hemangiomas, entre 0,8 e 11 cm (média de 2,62 cm). A concordância entre a avaliação da seqüência com TE longo e o padrão-ouro foi insignificante (κ κ κ κ κ: 0,00-0,10). A concordância entre a avaliação da seqüência B-FFE e o padrão-ouro variou de substancial (κ κ κ κ κ: 0,62-0,71) a quase perfeita (κ κ κ κ κ: 0,86) para ambos os examinadores. A concordância interobservador e intra-observador para a seqüência B-FFE variou entre substancial (κ κ κ κ κ: 0,62-0,70) e quase perfeita (κ κ κ κ κ: 0,85-0,91). CONCLUSÃO: A técnica B-FFE apresenta eficácia e reprodutibilidade elevadas na diferenciação de cistos e hemangiomas. Unitermos: Fígado; Cisto; Hemangioma; Imagem por ressonância magnética. AbstractResumo

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“…In liver tumour with metastasis, higher T2 relaxation times were reported compared to normal liver [124]. For HCC, the values of T2 relaxation time calculated using 2 echo times (TE) were used to differentiate non-solid (such as haemangioma and abscesses) from solid liver ( such as, focal hyperplasia, metastases and HCC) lesions [128]. Both malignant and benign solid lesions showed similar T2 values.…”

Section: Relaxation Timesmentioning

confidence: 99%

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

Alghamdi¹

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Non-alcoholic fatty liver disease (NAFLD), a disorder associated with abnormal lipid accumulation within hepatocytes, is considered benign disorder in nature. However, in some cases it may progress to inflammation, nonalcoholic steatohepatitis (NASH), then cirrhosis, precancerous nodules and finally to hepatocellular carcinoma (HCC). NAFLD and NASH are both reversible with appropriate clinical intervention and lifestyle changes. In developed countries, the non-alcoholic fatty liver disease (NAFLD) is becoming one of the most common causes of precancerous and HCC lesions [1]. Unfortunately, most nodular lesions are detected too late with a poor prognosis. The discovery of markers that can predict which livers may progress to HCC would allow early intervention and potentially halting progress to HCC. This would be of great benefit at any stage up to precancerous lesions, however the earlier the better.Development of end stage liver malignancy would be decreased, resulting in decreased mortality from this disease.Histology is considered the reference standard for the assessment of fatty disease and nodular lesion in liver. However, there are significant drawbacks including invasiveness, small sample size and observer-dependence which limits its usefulness in evaluating liver disease.Magnetic resonance imaging is a non-invasive modality that can provide information on anatomical and physiological changes in the liver (e.g. fatty liver disease and HCC). MRI images are primarily assessed visually by expert radiologists looking for anatomical and contrast changes in the images compared to normal tissue. This qualitative method requires inspection of all datasets for abnormalities. Visual interpretation is subjective, labour intensive, and depends on the experience of the radiologist. This can introduce inter-observer variation and is suitable only when the pathology leads to sufficient contrast changes in the images acquired.MRI also allows the calculation of quantitative parameters like T1, T2 and diffusion values. These parameters are dependent on physical, chemical and microstructural properties of the tissue. When standard protocols are used, the calculation of these parameters should be independent of the observer. This has the potential for more precise characterization of changes that occur over time. Clinically, here has been limited utilization of these methods, as they generally require longer acquisition times and significant post processing of the images. Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text.

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Discrimination of benign from malignant hepatic lesions based on their T2-relaxation times calculated from moderately T2-weighted turbo SE sequence

Cited by 44 publications

References 21 publications

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

Liver haemangioma: common and uncommon findings and how to improve the differential diagnosis

Diferenciação entre cisto simples e hemangioma hepático utilizando seqüência de ressonância magnética ponderada em T2 com técnica gradiente-eco (B-FFE)

Magnetic resonance characterisation of developing hepatocellular carcinoma in a diet induced model of liver cancer in the rat

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