Julia Fruehwald-Pallamar, Presenter: Nothing to Disclose

Marion Jantsch, Abstract Co-Author: Nothing to Disclose

Negar Fakhrai MD, Abstract Co-Author: Nothing to Disclose

Stefan B Puchner, Abstract Co-Author: Nothing to Disclose

Christian J. Herold MD, Abstract Co-Author: Nothing to Disclose

Ahmed Ba-Ssalamah MD, Abstract Co-Author: Nothing to Disclose

Pseudolesions of the liver (e.g., focal steatosis or non-steatosis) are often challenging, especially when imaging patients with malignancies. We evaluated the efficacy of diffusion-weighted imaging (DWI) in the diagnostic work-up of pseudolesions.

Twenty-two patients (10 pts. with known primum, 12 pts. with suspected malignancy at US or CT) with pseudolesions of the liver were retrospectively analysed. MRI was performed on a clinical 3T scanner (body coil) using T1-GRE in-phase and opposed phase, T2-TSE-FS, diffusion-weighted sequences (b-value 50, 400, 800), and ADC mapping and dynamic post-contrast T1-VIBE-FS (13 patients received Gd-EB-DTPA and nine patients received gadolinium chelates). All images were analysed by two experienced radiologists independently. As a standard of reference, we used the T1-w GRE, in-phase and out of phase, and the contrast-enhanced series as well as long-term follow-up.

In 22 patients, we found 49 liver lesions. Of these, 43 were benign and 6 were malignant. Benign lesions included one FNH, 11 simple cysts, two haemangiomas and 29 pseudolesions (18 focal steatosis and 9 focal non-steatosis, and one fibrotic scar). All pseudolesions could be identified either on the T1-GRE in-phase and opposed phase images or on the contrast-enhanced series, or on both. None of the lesions were visible on the diffusion-weighted images.

Pseudolesions are invisible on DWI (negative predictive value = 1); therefore, DWI can be used as an additional sequence to increase significantly our diagnostic confidence in the differentiation between pseudolesions from other focal liver lesions.

DWI in the liver can be used to increase the diagnostic confidence in the differentiation of pseudolesions, especially when imaging patients with malignancies.

Fruehwald-Pallamar, J, Jantsch, M, Fakhrai, N, Puchner, S, Herold, C, Ba-Ssalamah, A, Confident Noninvasive Diagnosis of Pseudolesions of the Liver Using Diffusion-weighted Imaging at 3Tesla MRI.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8004374.html