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Invest Radiol. 2011 Jun;46(6):359-65. doi: 10.1097/RLI.0b013e3182104b77.

Distinguishing hepatic metastasis from hemangioma using gadoxetic acid-enhanced magnetic resonance imaging.

Author information

1
Department of Radiology, University of Yamanashi, Chuo, Japan.

Abstract

PURPOSE:

To retrospectively determine the findings of gadoxetic acid-enhanced magnetic resonance imaging (MRI) to distinguish hemangioma and metastasis of the liver.

MATERIALS AND METHODS:

The University's ethics committee approved this retrospective study. We assessed 45 patients without chronic liver disease who underwent gadoxetic acid-enhanced MRI. Diagnosis of 58 metastases and 47 hemangiomas was confirmed using histopathology or multimodality evaluation. Two radiologists independently assessed the following MRI findings of metastasis and hemangioma: their appearance on T2-weighted images (T2WI) and dynamic contrast enhancement patterns after gadoxetic acid administration. The metastasis and hemangioma findings were compared using Fisher exact test. The lesion-to-liver signal intensity ratio on hepatocyte phase was compared using the Mann-Whitney U test. Multivariate analysis was performed to identify independent imaging findings distinguishing the 2 diseases. Receiver operating characteristic analysis was used to estimate the diagnostic ability of gadoxetic acid-enhanced MRI to distinguish metastasis from hemangioma.

RESULTS:

The lesion-to-liver signal intensity ratio was comparable in both diseases. Peripheral-dot enhancement, ring-like, geographic, and moderate late-phase enhancement, rapid contrast filling, and bright signal on T2WI could differentiate between the 2 diseases. In multivariate analysis, bright signal on T2WI (94%-98% in hemangioma and 13%-25% in metastasis) and ring-like enhancement (4% in hemangioma and 58%-60% in metastasis) were the independent findings suggesting hemangioma and metastasis, respectively. The areas under the receiver operating characteristic curves to distinguish metastasis from hemangioma were 0.95 and 0.98 for Reader 1 and 2, respectively.

CONCLUSION:

Reliable findings to distinguish hepatic metastasis from hemangioma on gadoxetic acid-enhanced MRI were ring-like enhancement on arterial-phase images and bright signal on T2WI.

PMID:
21427594
DOI:
10.1097/RLI.0b013e3182104b77
[Indexed for MEDLINE]

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