You will receive email when new content is published. Among 14 patients, 12 patients underwent MR scan, 5 patients underwent CT scan and 3 patients underwent PET-CT. On CT, all 5 lesions showed hypodensity on non-contrast images and spoke-wheel enhancing pattern after contrast administration, and calcification was observed. {"url":"/signup-modal-props.json?lang=us"}, Baba Y, Sharma R, Gaillard F, et al. The hypointensity observed on T2-weighted MRI volume12, Articlenumber:8 (2021) Suppose you are having a medical issue, and your physician recommends an MRI. WebA 44-year-old woman presented with high [18F]FDG uptake liver lesion after six courses of R-CHOP and radiotherapy for abdominal DLBCL, which was misdiagnosed as a hepatic invasion. 2020QNA059). Abdom Radiol (NY) 43:20752096, Yoneda N, Matsui O, Kitao A et al (2012) Hepatocyte transporter expression in FNH and FNH-like nodule: correlation with signal intensity on gadoxetic acid enhanced magnetic resonance images. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. The prevalence of FNH-like nodules after treatment with oxaliplatin is not known [56, 57]. It has become common around the world. The presence of hyperintensity leads to an increased risk of dementia, mortality, and stroke. The lesion shows heterogeneous enhancement on arterial phase(1 C) and portal phase(1D).
A 40-year-old woman with sigmoid adenocarcinoma and liver metastases treated with chemotherapy (XELOX regimen). Hyperenhancing metastases typically originate from primary neuroendocrine tumors, renal cell carcinoma, thyroid carcinoma, choriocarcinoma, and sarcomas. Due to the recent review literature, about 51.6% of SANT presented hypointensity on T2WI, showing a better sensitivity than spoken-wheel patten(48%). On MRI multiple lesions are observed in both hepatic lobes. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more Am J Surg Pathol. Gadoxetate disodium-enhanced MRI shows an intrahepatic mass-forming cholangiocarcinoma with (a) continuous rim enhancement on hepatic arterial phase and (b) a target pattern on hepatobiliary phase with peripheral hypointense rim (arrow) and inhomogeneous contrast media uptake with a central enhancing area (asterisk) likely related to fibrous stroma. Cite this article. The potential explanation of the ring pattern on HBP is suggested to be similar to that described for FNH-like nodules in vascular liver disorders because the causative mechanism of FNH-like nodules after treatment with oxaliplatin is considered sinusoidal obstruction syndrome [56, 57]. As technology advances, radiologists are bringing new MRI techniques and machines to the market. Click the topic below to receive emails when new articles are available. One case (8.3%) showed progressive eccentric enhancement. Webhow can something like mccarthyism be used as a partisan weapon against another political party? Abdom Imaging.
Some of the associated neuro-pathological issues are: In this case, its essential to understand the clinical significance of MRI hyperintensities. All Rights Reserved. Abdom Radiol (NY) 44(10):33123324. AJR Am J Roentgenol. Therefore, DWI may be more effective than enhanced CT, T2WI and dynamic MRI in diagnosing SANT, with features of hypointensity on DWI and hyperintensity on ADC map in few literature[8,9,10]. These nodules may show an hyperintense rim on HBP with a doughnut-like appearance (Fig.16) [90]. no financial relationships to ineligible companies to disclose. Liver Int 38:21342136, Vernuccio F, Ronot M, Dioguardi Burgio M et al (2020) Long-term evolution of hepatocellular adenomas at MRI follow-up. It also acts as a practical framework that allows the radiologists to plan the overall treatment. However, a possible explanation is the presence of marked hepatic steatosis that reduces signal intensity of background liver on T1-weighted pre- and post-contrast imagesincluding the HBPand modifies the relative signal intensity of HCAs [32]. The lesion shows heterogeneous enhancement on arterial phase(1 C) and portal phase(1D). PubMed One (8.3%) showed marked enhancement on arterial phase and remained hyperintensity relative to the spleen. statement and Unable to process the form. Although FNH may increase in size in 315% of cases, these lesions do not evolve to malignancy and their management is conservative [27, 28]. suggested that may be due to continued enhancement of the angiomatous nodules with delayed enhancement of the fibrous tissue. Abdominal applications of diffusion-weighted magnetic resonance imaging: where do we stand. 1A. Hyperintensity on HBP in a cirrhotic liver usually indicates benignity, but well-differentiated HCC in cirrhotic patients may also show hyperintensity on HBP. Metastases must be differentiated from other benign or malignant liver lesions that may occur in these patients. Monoacinar nodules are usually 0.110mm in diameter, while large multiacinar nodules are usually 515mm in diameter [26]. Morani AC, Elsayes KM, Liu PS, Weadock WJ, Szklaruk J, Dillman JR, et al. https://doi.org/10.1007/s00330-020-06687-y, Tsuboyama T, Onishi H, Kim T et al (2010) Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid-enhanced MR imagingcorrelation with expression of sinusoidal and canalicular transporters and bile accumulation. T2: hyperintense relative to liver parenchyma, but less than the intensity of CSF or of a hepatic cyst T1 C + (Gd): often shows peripheral nodular discontinuous enhancement which progresses centripetally (inward) on delayed images hemangiomas tend to retain contrast on delayed (>5 minutes) contrast-enhanced images Journal of Gastroenterology and Hepatology.
38. Call to schedule. Signal intensity decrease can be observed on in-phase of T1WI, indicating the presence of hemosiderin deposition due to old hemorrhage. Manage cookies/Do not sell my data we use in the preference centre. Arterial phase hypervascular lesions include FNH, adenoma, HCC, and metastases from NET, melanoma, renal cell carcinoma, and (sometimes) breast cancer. Theyre found in as many as 30 percent of people over the age of 40. The lesions were biopsied
Abdom Radiol (NY) 45(8):24092417, Article [1] Patients with SANT usually were asymptomatic and identified incidentally on imaging. 2014;39(5):4701. You've successfully added to your alerts. Expert Rev Gastroenterol Hepatol 10:671678, Vilgrain V, Paradis V, Van Wettere M et al (2018) Benign and malignant hepatocellular lesions in patients with vascular liver diseases. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more hypointense scars in the center. 2019;98(17):e15154. It helps in accurately diagnosing and assessing the diseases. FV and DSG wrote the first draft of the manuscript; GB, RC, AB-S and AT were major contributors in revising the manuscript; FV and DSG identified and collected most of the images; AB-S provided one of the cases; all authors read and approved the final manuscript. MZ designed and conducted the study. The cause for T2-weighted hypointensity may not be, however, always recognized, and only pathologic correlation may provide the answer. Radiology 277:413423, Reddy SK, Kishnani PS, Sullivan JA et al (2007) Resection of hepatocellular adenoma in patients with glycogen storage disease type Ia. Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. https://doi.org/10.1007/s00330-020-06726-8, Denecke T, Steffen IG, Agarwal S et al (2012) Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI. A 46-year-old woman with clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma. PubMedGoogle Scholar. Staff Login 1C and D and 2B and C). The morphology of cirrhosis. Eur Radiol 21:20562066, Liu X, Zou L, Liu F, Zhou Y, Song B (2013) Gadoxetic acid disodium-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: a meta-analysis. WebIf it does cause problems, your symptoms will depend on the type you have. WebT1 and t2 hyperintense lesion in left aspect of the t2 vertebral body, which loses signal on inversion recovery imaging felt to reflect a hemangioma. Top row: 53-year-old woman with breast cancer and focal nodular hyperplasia. Correspondence to Cysts are commonly found in adults. 2015;39(2):3157. It is an accurate method of detecting and confirming the diagnosis. Federica Vernuccio. [69] showed an increased expression of aberrant OATP1B3 (i.e., the protein involved in hepatocyte contrast uptake), Wlcek et al. However, HCCs show contrast uptake on HBP in 8.814% of the cases [76, 79]. In cirrhotic patients, well-differentiated HCC may show contrast uptake in the HBP in 914% of the cases. Therefore, the doctors focus on neurological evaluation when assessing the MRI reports providing the diagnosis accordingly. Finally, in cirrhotic patients with prior history of HCC, HBP images are helpful to identify the loss of OATP8 expression in hypervascular lesions lacking washout to identify their progression toward malignancy [75,76,77,78] and to differentiate between malignancy and other benign entities such as regenerative nodules or multiacinar regenerative nodules that in some cases may pose diagnostic challenges. SANT is hypointense on non-contrast CT imaging with progressive enhancement after contrast administration. WebDiscrete lesion in segment 7 on 19-28 measuring 2.9 x 2.6 cm corresponding to abnormality on recent ultrasound dated 2/27/2023. Abdom Imaging 35:337345, Vernuccio F, Cannella R, Meyer M et al (2019) LI-RADS: diagnostic performance of hepatobiliary phase hypointensity and major imaging features of LR-3 and LR-4 lesions measuring 1019 mm with arterial phase hyperenhancement. It provides a more clear and visible image of the tissues. Liver Int 39:158167, Yoneda N, Matsui O, Kitao A et al (2012b) Beta-catenin-activated hepatocellular adenoma showing hyperintensity on hepatobiliary-phase gadoxetic-enhanced magnetic resonance imaging and overexpression of OATP8. Correspondence to Eur Radiol. We hypothesize one of them was the hyperintensity on T1WI or hyperdensity on unenhanced CT covered by hypointensity/hypodensity formed by massive fibrosis. Informed consent was not required. Underlying pathology generally shows single layer lining with cuboidal to columnar epithelial cells. Eur J Gastroenterol Hepatol 22:12531259, Vilgrain V, Lewin M, Vons C et al (1999) Hepatic nodules in BuddChiari syndrome: imaging features. Another possible reason could be that some HCAs included in these studies were in fact mixed -catenin activated and inflammatory HCA. 2005;20(10):1478-1487. AJR Am J Roentgenol 188:459463, Galia M, Taibbi A, Marin D et al (2014) Focal lesions in cirrhotic liver: what else beyond hepatocellular carcinoma? 3 patients underwent PET-CT. A: On T1-weighted images, the hepatic lesion shows low signal intensity; B: On T2-weighted images, the lesion shows hyperintense signal intensity; C: In the arterial phase, the lesion remains unenhanced; D, E: During the portal and delayed phases, the lesion displays peripheral enhancement with a centripetal progression. Symmetrical cerebral T2/FLAIR hyperintensitiesare seen in a broad range of pathologies. The median tumor diameter was 6.5 cm. Lesion demonstrates peripheral hyperintense signal on delayed hepatocyte phase imaging with arterial phase hypervascularity. Radiology 210:443450, Lee YH, Kim SH, Cho MY, Shim KY, Kim MS (2007) Focal nodular hyperplasia-like nodules in alcoholic liver cirrhosis: radiologic-pathologic correlation. Cystic change or necrosis was absent in all 12 patients. Cirrhosis-associated regenerative nodules are innumerable well-defined nodules scattered within cirrhotic parenchyma, surrounded by scar tissue and typically measuring 115mm in diameter [26]. Gadopentetate dimeglumine (Magnevist, Bayer Schering Pharma, Berlin, Germany), was administered at a dose of 0.1 mmol/kg and at a rate of 2 ml/s followed by using a power injector (Spectris; Medrad, Pittsburgh, PA, USA). Although radiologic differential diagnosis is difficult, some features may help confident differentiation. Gadoxetate disodium-enhanced MRI shows two FNH-like nodules (arrows) that are hyperintense in the hepatobiliary phase with central small hypointensity due to a central scar. Less commonly, hepatic lesions may show variable signal characteristics on hepatobiliary phase. In non-cirrhotic patients, focal hepatic observations that show hyperintensity in the hepatobiliary phase are usually benign and typically include focal nodular hyperplasia. Unenhanced axial CT image (2A) shows a hypodense lesion in spleen. CD8 and CD86 positive expression was presented in 6 and 7 cases respectively. Jpn J Radiol 31:915, Onishi H, Theisen D, Zachoval R, Reiser MF, Zech CJ (2019) Intrahepatic diffuse periportal enhancement patterns on hepatobiliary phase gadoxetate disodium-enhanced liver MR images: do they correspond to periportal hyperintense patterns on T2-weighted images? Although the typical pattern of intrahepatic cholangiocarcinoma on dynamic studies (i.e., irregular peripheral enhancement in the hepatic arterial phase and gradual centripetal enhancement on following phases) usually allows a confident diagnosis, HBP images are useful to increase lesion conspicuity and better delineate daughter nodules and intrahepatic metastasis [73]. The T2 MRI hyperintensity is often a sign of demyelinating illnesses. 1F and 2E) and 2 cases (16.7%) showed slightly hyperintensity on DWI. 2008;9 Suppl:S52-5. These also involve different imaging patterns that highlight the different kinds of tissues. Lesions with intermediate highT2 SI had a higher tendency to progress compared with lesions with low-to-isointense SI (odds ratio = 8.16, P = 0.040). J Hepatol 57:421429, Article
A 40-year-old woman with sigmoid adenocarcinoma and liver metastases treated with chemotherapy (XELOX regimen). Hyperenhancing metastases typically originate from primary neuroendocrine tumors, renal cell carcinoma, thyroid carcinoma, choriocarcinoma, and sarcomas. Due to the recent review literature, about 51.6% of SANT presented hypointensity on T2WI, showing a better sensitivity than spoken-wheel patten(48%). On MRI multiple lesions are observed in both hepatic lobes. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more Am J Surg Pathol. Gadoxetate disodium-enhanced MRI shows an intrahepatic mass-forming cholangiocarcinoma with (a) continuous rim enhancement on hepatic arterial phase and (b) a target pattern on hepatobiliary phase with peripheral hypointense rim (arrow) and inhomogeneous contrast media uptake with a central enhancing area (asterisk) likely related to fibrous stroma. Cite this article. The potential explanation of the ring pattern on HBP is suggested to be similar to that described for FNH-like nodules in vascular liver disorders because the causative mechanism of FNH-like nodules after treatment with oxaliplatin is considered sinusoidal obstruction syndrome [56, 57]. As technology advances, radiologists are bringing new MRI techniques and machines to the market. Click the topic below to receive emails when new articles are available. One case (8.3%) showed progressive eccentric enhancement. Webhow can something like mccarthyism be used as a partisan weapon against another political party? Abdom Imaging.
Some of the associated neuro-pathological issues are: In this case, its essential to understand the clinical significance of MRI hyperintensities. All Rights Reserved. Abdom Radiol (NY) 44(10):33123324. AJR Am J Roentgenol. Therefore, DWI may be more effective than enhanced CT, T2WI and dynamic MRI in diagnosing SANT, with features of hypointensity on DWI and hyperintensity on ADC map in few literature[8,9,10]. These nodules may show an hyperintense rim on HBP with a doughnut-like appearance (Fig.16) [90]. no financial relationships to ineligible companies to disclose. Liver Int 38:21342136, Vernuccio F, Ronot M, Dioguardi Burgio M et al (2020) Long-term evolution of hepatocellular adenomas at MRI follow-up. It also acts as a practical framework that allows the radiologists to plan the overall treatment. However, a possible explanation is the presence of marked hepatic steatosis that reduces signal intensity of background liver on T1-weighted pre- and post-contrast imagesincluding the HBPand modifies the relative signal intensity of HCAs [32]. The lesion shows heterogeneous enhancement on arterial phase(1 C) and portal phase(1D). PubMed One (8.3%) showed marked enhancement on arterial phase and remained hyperintensity relative to the spleen. statement and Unable to process the form. Although FNH may increase in size in 315% of cases, these lesions do not evolve to malignancy and their management is conservative [27, 28]. suggested that may be due to continued enhancement of the angiomatous nodules with delayed enhancement of the fibrous tissue. Abdominal applications of diffusion-weighted magnetic resonance imaging: where do we stand. 1A. Hyperintensity on HBP in a cirrhotic liver usually indicates benignity, but well-differentiated HCC in cirrhotic patients may also show hyperintensity on HBP. Metastases must be differentiated from other benign or malignant liver lesions that may occur in these patients. Monoacinar nodules are usually 0.110mm in diameter, while large multiacinar nodules are usually 515mm in diameter [26]. Morani AC, Elsayes KM, Liu PS, Weadock WJ, Szklaruk J, Dillman JR, et al. https://doi.org/10.1007/s00330-020-06687-y, Tsuboyama T, Onishi H, Kim T et al (2010) Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid-enhanced MR imagingcorrelation with expression of sinusoidal and canalicular transporters and bile accumulation. T2: hyperintense relative to liver parenchyma, but less than the intensity of CSF or of a hepatic cyst T1 C + (Gd): often shows peripheral nodular discontinuous enhancement which progresses centripetally (inward) on delayed images hemangiomas tend to retain contrast on delayed (>5 minutes) contrast-enhanced images Journal of Gastroenterology and Hepatology.
38. Call to schedule. Signal intensity decrease can be observed on in-phase of T1WI, indicating the presence of hemosiderin deposition due to old hemorrhage. Manage cookies/Do not sell my data we use in the preference centre. Arterial phase hypervascular lesions include FNH, adenoma, HCC, and metastases from NET, melanoma, renal cell carcinoma, and (sometimes) breast cancer. Theyre found in as many as 30 percent of people over the age of 40. The lesions were biopsied
Abdom Radiol (NY) 45(8):24092417, Article [1] Patients with SANT usually were asymptomatic and identified incidentally on imaging. 2014;39(5):4701. You've successfully added to your alerts. Expert Rev Gastroenterol Hepatol 10:671678, Vilgrain V, Paradis V, Van Wettere M et al (2018) Benign and malignant hepatocellular lesions in patients with vascular liver diseases. T2-weighted images(1E) and DWI(1 F) show a hypointensity lesion with more hypointense scars in the center. 2019;98(17):e15154. It helps in accurately diagnosing and assessing the diseases. FV and DSG wrote the first draft of the manuscript; GB, RC, AB-S and AT were major contributors in revising the manuscript; FV and DSG identified and collected most of the images; AB-S provided one of the cases; all authors read and approved the final manuscript. MZ designed and conducted the study. The cause for T2-weighted hypointensity may not be, however, always recognized, and only pathologic correlation may provide the answer. Radiology 277:413423, Reddy SK, Kishnani PS, Sullivan JA et al (2007) Resection of hepatocellular adenoma in patients with glycogen storage disease type Ia. Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. https://doi.org/10.1007/s00330-020-06726-8, Denecke T, Steffen IG, Agarwal S et al (2012) Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI. A 46-year-old woman with clinical history of oral contraceptive use and pathology-proven hepatocellular adenoma. PubMedGoogle Scholar. Staff Login 1C and D and 2B and C). The morphology of cirrhosis. Eur Radiol 21:20562066, Liu X, Zou L, Liu F, Zhou Y, Song B (2013) Gadoxetic acid disodium-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: a meta-analysis. WebIf it does cause problems, your symptoms will depend on the type you have. WebT1 and t2 hyperintense lesion in left aspect of the t2 vertebral body, which loses signal on inversion recovery imaging felt to reflect a hemangioma. Top row: 53-year-old woman with breast cancer and focal nodular hyperplasia. Correspondence to Cysts are commonly found in adults. 2015;39(2):3157. It is an accurate method of detecting and confirming the diagnosis. Federica Vernuccio. [69] showed an increased expression of aberrant OATP1B3 (i.e., the protein involved in hepatocyte contrast uptake), Wlcek et al. However, HCCs show contrast uptake on HBP in 8.814% of the cases [76, 79]. In cirrhotic patients, well-differentiated HCC may show contrast uptake in the HBP in 914% of the cases. Therefore, the doctors focus on neurological evaluation when assessing the MRI reports providing the diagnosis accordingly. Finally, in cirrhotic patients with prior history of HCC, HBP images are helpful to identify the loss of OATP8 expression in hypervascular lesions lacking washout to identify their progression toward malignancy [75,76,77,78] and to differentiate between malignancy and other benign entities such as regenerative nodules or multiacinar regenerative nodules that in some cases may pose diagnostic challenges. SANT is hypointense on non-contrast CT imaging with progressive enhancement after contrast administration. WebDiscrete lesion in segment 7 on 19-28 measuring 2.9 x 2.6 cm corresponding to abnormality on recent ultrasound dated 2/27/2023. Abdom Imaging 35:337345, Vernuccio F, Cannella R, Meyer M et al (2019) LI-RADS: diagnostic performance of hepatobiliary phase hypointensity and major imaging features of LR-3 and LR-4 lesions measuring 1019 mm with arterial phase hyperenhancement. It provides a more clear and visible image of the tissues. Liver Int 39:158167, Yoneda N, Matsui O, Kitao A et al (2012b) Beta-catenin-activated hepatocellular adenoma showing hyperintensity on hepatobiliary-phase gadoxetic-enhanced magnetic resonance imaging and overexpression of OATP8. Correspondence to Eur Radiol. We hypothesize one of them was the hyperintensity on T1WI or hyperdensity on unenhanced CT covered by hypointensity/hypodensity formed by massive fibrosis. Informed consent was not required. Underlying pathology generally shows single layer lining with cuboidal to columnar epithelial cells. Eur J Gastroenterol Hepatol 22:12531259, Vilgrain V, Lewin M, Vons C et al (1999) Hepatic nodules in BuddChiari syndrome: imaging features. Another possible reason could be that some HCAs included in these studies were in fact mixed -catenin activated and inflammatory HCA. 2005;20(10):1478-1487. AJR Am J Roentgenol 188:459463, Galia M, Taibbi A, Marin D et al (2014) Focal lesions in cirrhotic liver: what else beyond hepatocellular carcinoma? 3 patients underwent PET-CT. A: On T1-weighted images, the hepatic lesion shows low signal intensity; B: On T2-weighted images, the lesion shows hyperintense signal intensity; C: In the arterial phase, the lesion remains unenhanced; D, E: During the portal and delayed phases, the lesion displays peripheral enhancement with a centripetal progression. Symmetrical cerebral T2/FLAIR hyperintensitiesare seen in a broad range of pathologies. The median tumor diameter was 6.5 cm. Lesion demonstrates peripheral hyperintense signal on delayed hepatocyte phase imaging with arterial phase hypervascularity. Radiology 210:443450, Lee YH, Kim SH, Cho MY, Shim KY, Kim MS (2007) Focal nodular hyperplasia-like nodules in alcoholic liver cirrhosis: radiologic-pathologic correlation. Cystic change or necrosis was absent in all 12 patients. Cirrhosis-associated regenerative nodules are innumerable well-defined nodules scattered within cirrhotic parenchyma, surrounded by scar tissue and typically measuring 115mm in diameter [26]. Gadopentetate dimeglumine (Magnevist, Bayer Schering Pharma, Berlin, Germany), was administered at a dose of 0.1 mmol/kg and at a rate of 2 ml/s followed by using a power injector (Spectris; Medrad, Pittsburgh, PA, USA). Although radiologic differential diagnosis is difficult, some features may help confident differentiation. Gadoxetate disodium-enhanced MRI shows two FNH-like nodules (arrows) that are hyperintense in the hepatobiliary phase with central small hypointensity due to a central scar. Less commonly, hepatic lesions may show variable signal characteristics on hepatobiliary phase. In non-cirrhotic patients, focal hepatic observations that show hyperintensity in the hepatobiliary phase are usually benign and typically include focal nodular hyperplasia. Unenhanced axial CT image (2A) shows a hypodense lesion in spleen. CD8 and CD86 positive expression was presented in 6 and 7 cases respectively. Jpn J Radiol 31:915, Onishi H, Theisen D, Zachoval R, Reiser MF, Zech CJ (2019) Intrahepatic diffuse periportal enhancement patterns on hepatobiliary phase gadoxetate disodium-enhanced liver MR images: do they correspond to periportal hyperintense patterns on T2-weighted images? Although the typical pattern of intrahepatic cholangiocarcinoma on dynamic studies (i.e., irregular peripheral enhancement in the hepatic arterial phase and gradual centripetal enhancement on following phases) usually allows a confident diagnosis, HBP images are useful to increase lesion conspicuity and better delineate daughter nodules and intrahepatic metastasis [73]. The T2 MRI hyperintensity is often a sign of demyelinating illnesses. 1F and 2E) and 2 cases (16.7%) showed slightly hyperintensity on DWI. 2008;9 Suppl:S52-5. These also involve different imaging patterns that highlight the different kinds of tissues. Lesions with intermediate highT2 SI had a higher tendency to progress compared with lesions with low-to-isointense SI (odds ratio = 8.16, P = 0.040). J Hepatol 57:421429, Article