ABSTRACT
OBJECTIVE: To evaluate the diagnostic yield of MRI performed for characterization of focal hepatic lesions that are interpreted as indeterminate on CT. PATIENTS AND METHODS: In a retrospective investigation, 124 indeterminate focal hepatic lesions in 96 patients were identified on CT examinations over 5 years from 1997 to 2001. All patients had MRI performed for the liver within 6 weeks of their CT examination. CT and MR images were reviewed independently by two separate groups of two radiologists. The value of MRI in characterizing these lesions was assessed. Diagnoses were confirmed based on histology, characteristic imaging features, and clinical follow-up. RESULTS: MRI definitely characterized 73 lesions (58%) that were indeterminate on CT. MRI was accurate in 72/73 of these lesions. MRI could not definitely characterize 51 lesions (42%). Ten lesions were not visualized on MRI, and follow-up imaging confirmed that no lesion was present in eight of these cases (pseudolesions). CONCLUSION: MRI is valuable for the characterization of indeterminate focal hepatic lesions detected on CT.
ABSTRACT
Primary sclerosing cholangitis is a progressive cholestatic disease of unknown etiology leading to cirrhosis and liver failure. Several imaging modalities have been used to study this disease, including ultrasonography, computed tomography and hepatobiliary scintigraphy, but accurate diagnosis was found to be best made with endoscopic retrograde cholangiopancreatography or direct cholangiography. However, these 2 methods are invasive and may produce serious complications. Magnetic resonance cholangiopancreatography is a noninvasive imaging technique that has become very useful for diagnosing primary sclerosing cholangitis. Contrast enhanced magnetic resonance imaging provides pertinent information of extraductal abnormalities in addition to biliary ductal changes.
