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Evaluation of Liver Diffusion Isotropy and Characterization of Focal Hepatic Lesions with Two Single-Shot Echo-planar MR Imaging Sequences: Prospective Study in 66 Patients¹

¹ From the Department of Radiology, Hôpital Beaujon and Laboratoire d’Imagerie Médicale Paris-Nord, Faculté de Médecine Paris VII, Clichy, France (B.T., V.V., E.D., J.L.D., Y.M.); and Department of Radiology, University of California San Francisco, 505 Parnassus Ave, Rm M-372, Box 0628, San Francisco, CA 94143 (B.T., B.F.). From the 2001 RSNA scientific assembly. Received November 27, 2001; revision requested February 7, 2002; revision received March 15; accepted May 7. Supported by a grant from the French Radiology Society. Address correspondence to B.T. (e-mail: bachir.taouli@radiology.ucsf.edu).

View larger version (11K): [in a new window]   Figure 1. Scatterplot of isotropic ADCs of hepatic metastases (METS), HCCs, benign hepatocellular lesions (BHL), hemangiomas (HEM.), and cysts obtained with the first diffusion-weighted MR sequence.

View larger version (125K): [in a new window]   Figure 2a. Images in a 33-year-old man with hepatic metastases from a pancreatic neuroendocrine tumor. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show hyperintense metastases (arrows) of the right and left hepatic lobes, with no attenuation at b = 500 sec/mm2. The primary tumor (arrowhead) is located in the pancreatic head. (c) Mapping image had an ADC of 0.5 x 10-3 mm2/sec.

View larger version (93K): [in a new window]   Figure 2b. Images in a 33-year-old man with hepatic metastases from a pancreatic neuroendocrine tumor. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show hyperintense metastases (arrows) of the right and left hepatic lobes, with no attenuation at b = 500 sec/mm2. The primary tumor (arrowhead) is located in the pancreatic head. (c) Mapping image had an ADC of 0.5 x 10-3 mm2/sec.

View larger version (135K): [in a new window]   Figure 2c. Images in a 33-year-old man with hepatic metastases from a pancreatic neuroendocrine tumor. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show hyperintense metastases (arrows) of the right and left hepatic lobes, with no attenuation at b = 500 sec/mm2. The primary tumor (arrowhead) is located in the pancreatic head. (c) Mapping image had an ADC of 0.5 x 10-3 mm2/sec.

View larger version (115K): [in a new window]   Figure 3a. Images in a 60-year-old woman with hepatic metastasis from colon carcinoma. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show hyperintense metastasis (arrow) of the right hepatic lobe, with no attenuation at b = 500 sec/mm2. ADC was 1.34 x 10-3 mm2/sec.

View larger version (111K): [in a new window]   Figure 3b. Images in a 60-year-old woman with hepatic metastasis from colon carcinoma. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show hyperintense metastasis (arrow) of the right hepatic lobe, with no attenuation at b = 500 sec/mm2. ADC was 1.34 x 10-3 mm2/sec.

View larger version (119K): [in a new window]   Figure 4a. Images in a 58-year-old man with HCC of the liver related to chronic hepatitis B. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show HCC (arrow) of the caudate lobe with central areas of hyperintensity, remaining hyperintense at b = 500 sec/mm2. ADC was 1.31 x 10-3 mm2/sec.

View larger version (115K): [in a new window]   Figure 4b. Images in a 58-year-old man with HCC of the liver related to chronic hepatitis B. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show HCC (arrow) of the caudate lobe with central areas of hyperintensity, remaining hyperintense at b = 500 sec/mm2. ADC was 1.31 x 10-3 mm2/sec.

View larger version (115K): [in a new window]   Figure 5a. Images in a 65-year-old woman with hepatic hemangioma. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show hyperintense hemangioma (arrow) of the left hepatic lobe at b = 500 sec/mm2. ADC was 3.18 x 10-3 mm2/sec.

View larger version (113K): [in a new window]   Figure 5b. Images in a 65-year-old woman with hepatic hemangioma. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show hyperintense hemangioma (arrow) of the left hepatic lobe at b = 500 sec/mm2. ADC was 3.18 x 10-3 mm2/sec.

View larger version (112K): [in a new window]   Figure 6a. Images in a 45-year-old woman with adult polycystic renal disease and multiple hepatic cysts. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show multiple hyperintense cysts of the liver and kidney at b = 500 sec/mm2. ADC of the largest cyst (arrow) was 3.3 x 10-3 mm2/sec.

View larger version (95K): [in a new window]   Figure 6b. Images in a 45-year-old woman with adult polycystic renal disease and multiple hepatic cysts. Transverse single-shot echo-planar 2,400/104 MR images at (a) b = 0 sec/mm2 and (b) b = 500 sec/mm2 show multiple hyperintense cysts of the liver and kidney at b = 500 sec/mm2. ADC of the largest cyst (arrow) was 3.3 x 10-3 mm2/sec.

View larger version (12K): [in a new window]   Figure 7. Scatterplot of the isotropic ADCs of malignant and benign focal hepatic lesions obtained with the first diffusion-weighted MR sequence. ADCs of benign and malignant lesions overlap between 1.0 and 2.0 x 10-3 mm2/sec.