Generic placeholder image

Current Medical Imaging

Author(s): Joanna Podgorska, Agnieszka Anysz-Grodzicka* and Andrzej Cieszanowski

DOI: 10.2174/1573405614666171218154838

DownloadDownload PDF Flyer Cite As
State-of-the-art MR Imaging of Fat-containing Focal Lesions of the Liver

Page: [435 - 442] Pages: 8

  • * (Excluding Mailing and Handling)

Abstract

Background: Fat can be identified in numerous liver lesions, and usually is not a specific finding. Distinguishing between different kinds of fatty deposits is an important part of differential diagnosis. Magnetic Resonance Imaging (MRI) is superior to other imaging techniques because it allows distinguishing intracellular from macroscopic fat.

Discussion: Intracellular lipid may be found in focal hepatic steatosis, hepatic adenoma, hepatocellular carcinoma and, less commonly, in focal nodular hyperplasia as well as regenerative and dysplastic nodules. Macroscopic fat is seen in angiomyolipoma, lipoma, metastases from fatcontaining neoplasms, primary or metastatic liposarcoma, hydatid cyst, pseudolipoma of the Glisson capsule, pericaval fat collection, lipopeliosis, hepatic teratoma, focal hepatic extramedullary haematopoiesis and adrenal rest tumour.

Conclusion: Liver nodules should be characterised with regard to underlying liver condition, MRI characteristics and contrast enhancement pattern, including hepatobiliary phase. In many cases, identification of fatty content may help narrowing the differential diagnosis.

Keywords: Liver neoplasms, MR imaging, fat containing, hepatobiliary contrast agents, lipid detection, intracellular fat, macroscopic fat.

Graphical Abstract

[1]
Dioguardi Burgio M, Bruno O, Agnello F, et al. The cheating liver: imaging of focal steatosis and fatty sparing. Expert Rev Gastroenterol Hepatol 2016; 10(6): 671-8.
[2]
Pokharel SS, Macura KJ, Kamel IR, Zaheer A. Current MR imaging lipid detection techniques for diagnosis of lesions in the abdomen and pelvis. Radiographics 2013; 33(3): 681-702.
[3]
Brunt EM, Tiniakos DG. Histopathology of nonalcoholic fatty liver disease. World J Gastroenterol 2010; 16(42): 5286-96.
[4]
Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB. Fatty liver: Imaging patterns and pitfalls. Radiographics 2006; 26: 1637-53.
[5]
Venkatesh SK, Hennedige T, Johnson GB, Hough DM, Fletcher JG. Imaging patterns and focal lesions in fatty liver: A pictorial review. Abdom Radiol 2017; 1-19.
[6]
Rebouissou S, Bioulac-Sage P, Zucman-Rossi J. Molecular pathogenesis of focal nodular hyperplasia and hepatocellular adenoma. J Hepatol 2008; 48(1): 163-70.
[7]
Grazioli L, Bondioni MP, Haradome H, et al. Hepatocellular adenoma and focal nodular hyperplasia: Value of gadoxetic acid–enhanced mr imaging in differential diagnosis. Radiology 2012; 262(2): 520-9.
[8]
Bieze M, Van Den Esschert JW, Nio CY, et al. Diagnostic accuracy of MRI in differentiating hepatocellular adenoma from focal nodular hyperplasia: Prospective study of the additional value of gadoxetate disodium. AJR Am J Roentgenol 2012; 199: 26-34.
[9]
Kumar V, Abbas AK, Fausto N, Aster JC. Kumar. Robbins and cotran pathologic basis of disease, professional edition. 8th ed. Amsterdam: Elsevier 2009.
[10]
Bruix J, Sherman M. Management of hepatocellular carcinoma: An update. Hepatology 2011; 53(3): 1020-2.
[11]
An C, Rakhmonova G, Choi J-Y, Kim M-J. Liver imaging reporting and data system (LI-RADS) version 2014: Understanding and application of the diagnostic algorithm. Clin Mol Hepatol 2016; 22(2): 296-307.
[12]
Park YS, Lee CH, Kim JW, Shin S, Park CM. Differentiation of hepatocellular carcinoma from its various mimickers in liver magnetic resonance imaging: What are the tips when using hepatocyte-specific agents? World J Gastroenterol 2016; 22(1): 284-99.
[13]
LI-RADS. The American College of Radiology, available from: https://nrdr.acr.org/lirads/ date of access 12-05-2017.
[14]
Prasad SR, Wang H, Rosas H, et al. Fat-containing lesions of the liver: radiologic-pathologic correlation. Radiographics 2005; 25(2): 321-31.
[15]
Vilgrain V. Focal nodular hyperplasia. Eur J Radiol 2006; 58(2): 236-45.
[16]
Hussain SM, Terkivatan T, Zondervan PE, et al. Focal Nodular Hyperplasia: Findings at state-of-the-art MR Imaging, US, CT, and Pathologic Analysis. Radiographics 2004; 24(1): 3-17.
[17]
Ronot M, Paradis V, Duran R, et al. MR findings of steatotic focal nodular hyperplasia and comparison with other fatty tumours. Eur Radiol 2013; 23(4): 914-23.
[18]
Klompenhouwer AJ, Verver D, Janki S, et al. Management of hepatic angiomyolipoma: A systematic review. Liver Int 2017; 37(9): 1272-80.
[19]
Yan F, Zeng M, Zhou K, et al. Hepatic angiomyolipoma: various appearances on two-phase contrast scanning of spiral CT. Eur J Radiol 2002; 41(1): 12-8.
[20]
Anysz-Grodzicka A, Pacho R, Grodzicki M, et al. Angiomyolipoma of the liver: Analysis of typical features and pitfalls based on own experience and literature. Clin Imaging 2013; 37(2): 320-6.
[21]
Pakala T, Molina M, Wu GY. Hepatic echinococcal cysts: A review. J Clin Transl Hepatol 2016; 4(1): 39-46.
[22]
Koken D, Cagli B, Tuncel SA, Sengul E, Yilmaz E, Unlu ME. Efficacy of diffusion-weighted MRI in the differentiation of all liver hydatid cyst types. J Med Imaging Radiat Oncol 2016; 60(1): 59-65.
[23]
Alghofaily KA, Saeedan M. Bin, Aljohani IM, et al. Hepatic hydatid disease complications: Review of imaging findings and clinical implications. Abdom Radiol 2017; 42(1): 199-210.
[24]
Mermi EU, Fidan N, Murat M. Focal biliary system obstruction and atypical liver mass: Intrabiliary ruptured cyst hydatid case report. Pol J Radiol 2017; 82: 110-3.
[25]
Gibo M, Murata S, Kuroki S. Pericaval fat collection mimicking an intracaval lesion on CT in patients with chronic liver disease. Abdom Imaging 2001; 26(5): 492-5.
[26]
Han BK, Im JG, Jung JW, Chung MJ, Yeon KM. Pericaval fat collection that mimics thrombosis of the inferior vena cava: Demonstration with use of multi-directional reformation CT. Radiology 1997; 203(1): 105-8.
[27]
Quinn AM, Guzman-Hartman G. Pseudolipoma of Glisson Capsule. Arch Pathol Lab Med 2003; 127: 503-4.
[28]
Basaran C, Karcaaltincaba M, Akata D, et al. Fat-containing lesions of the liver: Cross-sectional imaging findings with emphasis on MRI. AJR Am J Roentgenol 2005; 184(4): 1103-10.
[29]
Gupta P, Naran A, Auh YH, Chung JS. Focal intrahepatic extramedullary hematopoiesis presenting as fatty lesions. AJR Am J Roentgenol 2004; 182(4): 1031-2.
[30]
Georgiades CS, Neyman EG, Francis IR, Sneider MB, Fishman EK. Typical and atypical presentations of extramedullary hemopoiesis. AJR Am J Roentgenol 2002; 179(5): 1239-43.
[31]
Roberts AS, Shetty AS, Mellnick VM, Pickhardt PJ, Bhalla S, Menias CO. Extramedullary haematopoiesis: Radiological imaging features. Clin Radiol 2016; 71(9): 807-14.
[32]
Malek-Hosseini SA, Baezzat SR, Shamsaie A, et al. Huge immature teratoma of the liver in an adult: A case report and review of the literature. Clin J Gastroenterol 2010; 3(6): 332-6.
[33]
Brown B, Khalil B, Batra G, Rampersad B, Bruce J. Mature cystic teratoma arising at the porta hepatis: A diagnostic dilemma. J Pediatr Surg 2008; 43(4): e1-3.
[34]
Nakayama T, Yoshimitsu K, Irie H, et al. Fat in liver metastasis from renal cell carcinoma detected by chemical shift MR imaging. Abdom Imaging 2003; 28(5): 657-9.
[35]
Prakash M, Vyas S, Shanbhogue AKP, Kang M, Dey P, Khandelwal N. Case report: Fat-containing liver metastases from retroperitoneal liposarcoma. Indian J Radiol Imaging 2008; 18(3): 230-1.
[36]
Prasad SR, Wang H, Rosas H, et al. Fat-containing lesions of the liver: Radiologic-pathologic correlation. Radiographics 2005; 25(2): 321-31.
[37]
Ferrell L, Bass N, Roberts J, Ascher N. Lipopeliosis: Fat induced sinusoidal dilatation in transplanted liver mimicking peliosis hepatis. J Clin Pathol 1992; 45(12): 1109-10.
[38]
Shin YM. Hepatic adrenal rest tumor mimicking hepatocellular carcinoma. Korean J Hepatol 2010; 16(3): 338-41.