Diagnostic value of un-enhanced MRI in differentiation of hemangioma and metastasis
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 7
Abstract
Objective: To compare the role of un-enhanced MRI in the differentiation of hemangioma and metastasis. Materials and methods:By performing a retrospective computerized search for all subjects who underwent liver in Medical Imaging center of Imam Khomeini hospital between February 2013 and April 2017, we identified 87 patients with hemangioma and metastasis ( 43 men and 44women;age, 18–86years; mean age 51.1 years). Patients were referred to this center for first assessment of ultrasound-detected liver lesions. None of patients received previous medical or interventional treatment of any nature. All patients with hemangioma and metastasis larger than 1.5 cm were included in the study. Patients with Immune deficiency, treated liver tumors were excluded from the study. Images analysis was done according to the difference in the signal intensity, site, shape, size of the lesions and their relations to the surrounding structures at the several sequences (T1- weighted, T2-weighted and heavily T2 pulse sequences ) Then, we reviewed diffusion-weighted imaging (DWI) study with the b-value of 50,400 and 800 , ADC value measurements were performed by placing the regions of interest (ROIs) on ADC maps and carefully drawing manually to encompass the entire lesions, without necrotic cores if present. For lesions not easily identified on DWI, the locations were determined using T2-weighted images. The ROIs in the surrounding organ to avoided intrahepatic vessels and motion artifacts. The mean ADC value of each ADC was obtained. Results:A total of 141 lesions in 87 patients were assessed. Mean age of patients was 51.1 years [18-86]. Among the patients, 44 were female [50.5%] and 43 were male [49.5%]. There was not any significant difference in the gender between hemangioma and metastasis (p value: 0.14). Among all lesions, 62 were metastasis [43.9%] and 79 were benign [56.1%]. Final diagnosis of all hemangioma were proved by follow up [100%] and all of metastasis were proved by biopsy [100%] Conclusion: this study showed high efficacy of diffusion-weighted imaging compared to conventional MRI. Diffusion weighted imaging can reliably differentiate hemangioma from metastasis lesions. Diffusion weighted imaging should be implemented into routine imaging of hepatic lesions not characterized in other imaging modalities
Authors and Affiliations
Arvin Arian, Hayder Jasim Taher, FaridAzmoudeh Ardalan
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