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Differentiating focal eosinophilic liver disease from hepatic metastases using unenhanced and gadoxetic acid-enhanced MRI

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Abstract

Purpose

To examine the differential features of focal eosinophilic liver disease (FELD) from liver metastases on gadoxetic acid-enhanced MRI.

Materials

Twenty patients with 41 FELD and 20 patients with 55 metastases were enrolled in this study. Liver MRI consisted of precontrast 2D T1-weighted image (T1WI) and gadoxetic acid-enhanced 3D T1WI (arterial, portal, 20 min hepatocyte-selective phases), and a postcontrast T2WI. Images were analyzed for the margin and shape of the lesions; lesion conspicuity on T1- and T2WI; signal intensity of the lesions on 3D T1WI; presence of rim enhancement and misty signs; and presence of significant smaller lesions on the unenhanced T1WI (<50%) compared to hepatocyte phase image.

Results

Univariate analysis revealed the following significant parameters to favor FELD: a fuzzy margin, irregular shape, subtle signal intensity changes on T1- and T2WI, absence of target signs on the hepatocyte phase image, presence of misty signs, and size discrepancies on T1WI and hepatocyte phase images. Multivariate analysis revealed only a significantly smaller lesion size on T1WI compared to hepatocyte phase images to be predictive of FELD.

Conclusion

A significantly smaller lesion size on T1WI relative to hepatocyte phase image is the best predictor for identifying FELD on gadoxetic acid-enhanced MRI.

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Authors and Affiliations

  1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Young Kon Kim & Min Woo Lee

  2. Department of Radiology, Wonkwang University Hospital and Medical School, Iksan, Republic of Korea

    Young Hwan Lee

  3. Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Jeonju, Republic of Korea

    Chong Soo Kim

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  1. Young Kon Kim
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  2. Young Hwan Lee
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  3. Chong Soo Kim
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  4. Min Woo Lee
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Correspondence to Young Kon Kim.

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Kim, Y.K., Lee, Y.H., Kim, C.S. et al. Differentiating focal eosinophilic liver disease from hepatic metastases using unenhanced and gadoxetic acid-enhanced MRI. Abdom Imaging 36, 425–432 (2011). https://doi.org/10.1007/s00261-011-9752-7

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