AbstractIntroduction: It is not uncommon for clinicians to see focal liver lesions (FLLs), which can be anything from harmless hemangiomas to dangerous hepatocellular carcinoma (HCC) and metastases. In order to properly treat these lesions, an accurate diagnosis is required. The purpose of this research is to compare magnetic resonance imaging (MRI) results with histological ones in order to determine how well MRI can detect and characterize localized liver lesions.
Materials and Methods: This prospective study comprised 50 patients with localized liver lesions identified via ultrasonography or computed tomography (CT) and then assessed using MRI. This study was conducted at the Department of Radiology at Gouri Devi Institute of Medical Science and Hospital, Rajbandh, West Bengal, India from June 2021 to May 2022. Patients received MRI images with T1-weighted, T2-weighted, diffusion-weighted imaging (DWI), and contrast-enhanced dynamic imaging with gadolinium-based contrast agents. The imaging findings were analyzed according to lesion morphology, signal intensity, enhancement patterns, and diffusion restriction. All patients received biopsy or surgical resection, with histological findings serving as the reference standard. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI in identifying malignant and benign liver lesions were assessed.
Results: There were 30 cancerous tumors and 20 benign ones among the 50 individuals. To distinguish between malignant and benign lesions, MRI showed a sensitivity of 94%, specificity of 89%, PPV of 93%, and NPV of 90%. Malignant lesions affecting the liver were most commonly found as hepatocellular carcinoma (HCC) and metastatic liver lesions, respectively. In terms of benign lesions, hemangiomas, hepatic adenomas, and focal nodular hyperplasia (FNH) were detected most often. Even while most benign lesions showed facilitated diffusion on diffusion-weighted imaging (DWI), 85% of malignant lesions showed restricted diffusion. Contrast-enhanced sequences showed that malignant lesions had arterial-phase hyperenhancement with washout, but benign lesions showed distinctive enhancement patterns as homogenous enhancement in FNH and peripheral nodular enhancement in hemangiomas.
Conclusion: Magnetic resonance imaging (MRI) provides a very accurate picture of localized liver lesions and correlates very well with histological results. Diagnostic certainty in distinguishing benign from malignant liver lesions is greatly increased when morphologic evaluation, diffusion restriction, and dynamic contrast enhancement patterns are combined. To better characterize liver lesions, MRI should be regarded the imaging modality of choice. This will help reduce the need for biopsies that aren't essential and guide appropriate clinical therapy.
