STATE OF THE ART OF MRI IN THE DIAGNOSIS OF HEPATIC FOCAL LESIONS

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STATE OF THE ART OF MRI IN THE DIAGNOSIS OF HEPATIC FOCAL LESIONS

Journal Title: International Journal of Medical Science and Diagnosis Research (IJMSDR) - Year 2018, Vol 2, Issue 6

Abstract

Abstract: One of the most commonly encountered lesions is liver lesions. Thousands of patients undergo imaging for the work up of suspected or known liver masses annually. A spectrum of lesions ranging from harmlessly benign to aggressively malignant whose characterization has prognostic and therapeutic implications in known as Focal liver lesions. The application of MDCT and thin collimation, it is likely more that liver lesions will be detected will need additional imaging for characterization, most likely with MR imaging. While USG remains the modality of choice for screening purposes in liver imaging CECT liver performed using multi-detector scanners with volumetric data acquisition and multi-planar reconstruction capabilities has been the preferred hepatic imaging modality. MR contrast media take advantageof liver specific the affinity of certain compounds to concentrate in Kupffer cells or hepatocytes. Aim: to designed the characterization potential of MRI to evaluate the utility of Gd-BOPTA as a liver specific enhanced sequences. Material and methods: This is the prospective cross- section study which is carried out on 50 patients between the age group 20 to 70 years old visiting the ultrasound section of Shri Vinoba Bhave Civil Hospital in the Department of Radiology in a period of one year. All the patients were referred to the Department of Radiology were diagnosed to have focal liver lesions by sonography were included in the study. In this studies MR imaging was used on 1.5 T systems (General electrical medical systems). A dedicated phased array body coil was used. Further imaging of the liver lesions by Gd-BOPTA enhanced MRI Liver. Exclusion criteria were pregnant women, patients less than 18 years. Result: Total 50 patients were included of which 30 were males (60%) and 20 were females (40%). The male female ratio was 2:1 approximately between the age group 20 to 70 years old with most patients falling between 30 to 60 years. The mean age for malignant lesions was 51 years. The right lobe of liver was involved in 26 cases (52%), left lobe in 7cases (14%) and both lobes in 9 cases (18%). There were 32 benign and 18 malignant lesions. MR Imaging diagnoses and accurately characterized 92% of lesions which is based on MR Imaging of which 90% were done on T1W Gadolinium enhanced images alone and 80% on DWI-b value, 62% on T2WI and 54% on LAVA sequences. Conclusion: Gd-BOPTA (Gadobenate Dimeglumine) has pharmacokinetics, extra-cellular distribution and clinical safety comparable to conventional MR contrast media. The common benign lesions were liver abscess followed by hemangiomas and the common malignant lesions were metastases. Thus MR imaging is a powerful tool for the judgement of focal liver lesions. Keywords: Malignant, Benign, MRI Liver, Focal liver lesions, USG, Gadobenate dimeglumine,

Authors and Affiliations

Jayesh Solanki

Keywords

pharmacokinetics hemangiomas Malignant Benign MRI Liver Focal liver lesions USG Gadobenate dimeglumine.

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