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Cirrhosis or Chronic Hepatitis: Evaluation of Small (2-cm) Early-Enhancing Hepatic Lesions with Serial Contrast-enhanced Dynamic MR Imaging¹

¹ From the Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 Japan. Received December 3, 2001; revision requested February 14, 2002; revision received April 5; accepted June 24. Address correspondence to A.S. (e-mail: ayamechan51@hotmail.com).

View larger version (168K): [in a new window]   Figure 1a. MR images of a small early enhancing hepatic lesion that disappeared during 18-month follow-up in a 73-year-old woman with cirrhosis. (a) Arterial-phase contrast-enhanced dynamic MR image (150/6) obtained at the initial MR examination shows a small early enhancing round lesion (arrow) in the right hepatic lobe. (b) Arterial-phase contrast-enhanced dynamic MR image obtained 18 months later shows that the lesion seen in a has disappeared, which is indicative of an early enhancing pseudolesion.

View larger version (167K): [in a new window]   Figure 1b. MR images of a small early enhancing hepatic lesion that disappeared during 18-month follow-up in a 73-year-old woman with cirrhosis. (a) Arterial-phase contrast-enhanced dynamic MR image (150/6) obtained at the initial MR examination shows a small early enhancing round lesion (arrow) in the right hepatic lobe. (b) Arterial-phase contrast-enhanced dynamic MR image obtained 18 months later shows that the lesion seen in a has disappeared, which is indicative of an early enhancing pseudolesion.

View larger version (141K): [in a new window]   Figure 2a. MR images of a small early enhancing hepatic lesion that disappeared during 23-month follow-up in a 51-year-old woman with chronic hepatitis. (a) Arterial-phase contrast-enhanced dynamic MR image (155/4.1) obtained at the initial MR examination shows a round early enhancing lesion (arrow) at the dome of the liver. (b) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained 23 months later shows that the abnormality in a has disappeared, which is indicative of a perfusional pseudolesion.

View larger version (122K): [in a new window]   Figure 2b. MR images of a small early enhancing hepatic lesion that disappeared during 23-month follow-up in a 51-year-old woman with chronic hepatitis. (a) Arterial-phase contrast-enhanced dynamic MR image (155/4.1) obtained at the initial MR examination shows a round early enhancing lesion (arrow) at the dome of the liver. (b) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained 23 months later shows that the abnormality in a has disappeared, which is indicative of a perfusional pseudolesion.

View larger version (149K): [in a new window]   Figure 3a. MR images of a small early enhancing hepatic lesion that decreased in size during 21-month follow-up in a 76-year-old woman with cirrhosis. (a) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained at the initial MR examination demonstrates a small early enhancing lesion (arrow) in the right hepatic lobe. (b) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained 21 months later shows that the lesion seen in a has decreased in size and shows faint enhancement (arrow), which is indicative of a pseudolesion.

View larger version (152K): [in a new window]   Figure 3b. MR images of a small early enhancing hepatic lesion that decreased in size during 21-month follow-up in a 76-year-old woman with cirrhosis. (a) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained at the initial MR examination demonstrates a small early enhancing lesion (arrow) in the right hepatic lobe. (b) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained 21 months later shows that the lesion seen in a has decreased in size and shows faint enhancement (arrow), which is indicative of a pseudolesion.

View larger version (166K): [in a new window]   Figure 4a. MR images of a small early enhancing hepatic lesion that increased in size during 13-month follow-up in a 62-year-old man with cirrhosis. (a) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained at the initial MR examination shows a small round early enhancing lesion (arrow) in the right posterior segment of the liver. Subsegmental perfusion anomalies with faint enhancement and a straight border (arrowheads) are also seen in the right anterior and left lateral segments. (b) Arterial-phase contrast-enhanced dynamic MR image (150/6) obtained 13 months later shows that the lesion (arrow) has increased in size, which is indicative of HCC.

View larger version (164K): [in a new window]   Figure 4b. MR images of a small early enhancing hepatic lesion that increased in size during 13-month follow-up in a 62-year-old man with cirrhosis. (a) Arterial-phase contrast-enhanced dynamic MR image (6/2.4) obtained at the initial MR examination shows a small round early enhancing lesion (arrow) in the right posterior segment of the liver. Subsegmental perfusion anomalies with faint enhancement and a straight border (arrowheads) are also seen in the right anterior and left lateral segments. (b) Arterial-phase contrast-enhanced dynamic MR image (150/6) obtained 13 months later shows that the lesion (arrow) has increased in size, which is indicative of HCC.

View larger version (152K): [in a new window]   Figure 5a. MR images of a small early enhancing hepatic lesion with no interval change during 18-month follow-up in a 61-year-old woman with chronic hepatitis. (a) Arterial-phase contrast-enhanced dynamic MR image (155/4.1) obtained at the initial MR examination shows a small early enhancing round lesion (arrow in a and b) in the left medial segment of the liver. (b) Arterial-phase contrast-enhanced dynamic MR image obtained 18 months later shows no change in lesion size, which is indicative of a probable pseudolesion. Note the hemangioma (arrowhead in a and b) in the medial segment of the liver.

View larger version (157K): [in a new window]   Figure 5b. MR images of a small early enhancing hepatic lesion with no interval change during 18-month follow-up in a 61-year-old woman with chronic hepatitis. (a) Arterial-phase contrast-enhanced dynamic MR image (155/4.1) obtained at the initial MR examination shows a small early enhancing round lesion (arrow in a and b) in the left medial segment of the liver. (b) Arterial-phase contrast-enhanced dynamic MR image obtained 18 months later shows no change in lesion size, which is indicative of a probable pseudolesion. Note the hemangioma (arrowhead in a and b) in the medial segment of the liver.