1) To appreciate and understand the typical imaging appearances of common liver lesions. 2) To understand the algorithmic approach to liver lesion differential diagnosis. 3) To understand how information from the various pulse sequences and contrast agents contribute to liver lesion assessment.
Given the ubiquitousness of liver lesions on imaging studies, it is incumbent upon radiologists to accurately characterize these lesions and differentiate benign from malignant. While the vast majority of liver lesions are benign incurring no further treatment or management and their features need to be recognized, the management of indeterminate and malignant lesions ranges from percutaneous biopsy to surgery to chemotherapy and a confident diagnosis or differential diagnosis should be pursued before these invasive measures are undertaken. While many lesions are adequately characterized on other imaging modalities, many require further analysis with MRI and some may initially present at MR imaging. Given the wide array of pulse sequences and protocols and proliferation of MR contrast agents, assimilating all of the necessary imaging information to generate an accurate diagnosis or differential diagnosis can be challenging. MRI is considered the most comprehensive and accurate modality for noninvasive assessment of liver lesions and in the majority of cases, a confident lesion diagnosis is possible based on the composite information from multiple pulse sequences. While many lesions exhibit classic features rendering diagnosis straightforward, lesions occasionally demonstrate unusual or atypical features that may complicate accurate diagnosis and familiarity with these infrequent appearances is important for accurate characterization and discrimination between benign and malignant etiology. The utility of the various MRI pulse sequences and contrast agents will be discussed and a diagnostic algorithm will be presented to help classify and accurately diagnose liver lesions.
Roth, C,
Liver Lesion Differential Diagnosis. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/13010384.html
