MRI of the Liver: A Practical Guide

Cover......Page 1
T1-Weighted Imaging . . . . 16......Page 6
Hepatocellular Carcinoma in the Non-Cirrhotic Liver . . . . 1 19......Page 7
Part C: MRI in Diffuse Liver Disease......Page 8
References . . . . 3 6 3......Page 9
Index . . . . 3 9 3......Page 10
Why , When, and How to Perform MRI of the Liver......Page 12
An Introduction to the Role of MRI in Liver Disease......Page 14
CURRENT CHOICES FOR IMAGING THE LIVER......Page 15
DEFINING THE APPROPRIATE CLINICAL APPLICATIONS OF LIVER MRI......Page 16
REFERENCES......Page 17
T echniques for MRI of the Liver......Page 20
GRADIENTS, SAMPLING FREQUENCY, BANDWITH, AND ECHO TIME (TE)......Page 21
REDUCING BREATHING ARTIFACT......Page 22
First-Order Chemical Shift......Page 23
T2-WEIGHTED IMAGING......Page 24
SINGLE SHOT FSE SEQUENCES......Page 25
HYBRID SEQUENCES......Page 26
CHEMICAL SHIFT IMAGING......Page 27
IMAGING THE NON-COMPLIANT P A TIENT......Page 28
REFERENCES......Page 29
Contrast Agents for Liver MRI......Page 46
Choice of Acquisition Sequence Parameters......Page 47
T iming the Dynamic Acquisition Phases......Page 48
HEPATOCYTE AGENTS......Page 49
RETICULO-ENDOTHELIAL SYSTEM (KUPFFER CELL) AGENTS......Page 50
Choice of Acquisition Sequence Parameters......Page 51
Lesion Detection......Page 52
DUAL CONTRAST MRI......Page 53
REFERENCES......Page 54
Dual Contrast......Page 55
Normal and V ariant Anatomy, and Imaging Artifacts......Page 78
VENOUS ANATOMY......Page 79
T raumatic Arterio-Portal Shunts......Page 80
Para-Umbilical V einsÑThe V eins of Burow and the Inferior V ein of......Page 81
MRI Appearances......Page 82
ARTIFACTS FROM CLIPS, STENTS, COILS, ETC.......Page 83
REFERENCES......Page 84
MRI for Characterizing Focal Lesions in the Non-Cirrhotic Liver......Page 100
Cysts and Cyst-Like Lesions of the Liver......Page 102
OTHER DEVELOPMENTAL CYSTS......Page 103
HAMARTOMA AND BILIARY ADENOMA......Page 104
Differential Diagnosis of Larger Cystic Lesions......Page 105
REFERENCES......Page 106
Solid Masses in the Non-Cirrhotic Liver......Page 122
Pathology......Page 123
Atypical Features of FNH......Page 124
ADENOMA......Page 125
Differential Diagnosis......Page 126
MRI Appearances......Page 127
Co-Morbidities......Page 128
Differential Diagnosis......Page 129
HEPATOCELLULAR CARCINOMA IN THE NON-CIRRHOTIC LIVER......Page 130
MRI Appearances......Page 131
MRI Appearances......Page 132
MISCELLANEOUS TUMORS......Page 133
REFERENCES......Page 134
MRI in Diffuse Liver Disease......Page 184
Fat and the Liver......Page 186
CHEMICAL SHIFT MRI......Page 187
TUMORS IN THE F A TTY LIVER......Page 188
REFERENCES......Page 189
Structural and V ascular Changes in Diffuse Liver Disease......Page 204
MRI Appearances......Page 205
Genetic Hemochromatosis......Page 206
MRI Appearances of Iron Deposition......Page 207
BUDD-CHIARI SYNDROME......Page 208
MRI Appearances......Page 209
The Nodular Architecture of the Cirrhotic Liver......Page 210
MRI Appearances......Page 211
NODULAR REGENERATIVE HYPERPLASIA......Page 212
MRI Appearances......Page 213
REFERENCES......Page 214
Detecting Hepatocellular Carcinoma in the Cirrhotic Liver......Page 244
DYSPLASIA AND HCC......Page 245
MRI Appearances......Page 246
Hepatocyte-Specific Contrast Agents......Page 247
AN APPROACH TO THE DIFFERENTIAL DIAGNOSIS OF CIRRHOTIC NODULES......Page 248
Enhancement with Gadolinium......Page 249
Appearances Following T issue-Specific Contrast Agents......Page 250
Benign Hypervascular Nodules......Page 251
REFERENCES......Page 252
MRI in Metastatic Disease of the Liver......Page 276
Early Detection of Liver Metastases by MRI......Page 278
THE TRUE ACCURACY OF IMAGING......Page 279
Dynamic Gd-Enhancement......Page 280
T issue-Specific Contrast Agents......Page 281
RECOMMENDATIONS......Page 282
REFERENCES......Page 283
Characterization of Liver Metastases......Page 300
Morphology......Page 301
Signal Intensity on Unenhanced MR Images......Page 302
Contrast Enhancement Characteristics......Page 303
Distinguishing Liver Metastases from Benign Lesions......Page 304
Metastasis V ersus Hepatic Adenoma......Page 305
Distinguishing Metastases from Primary Liver Malignancies......Page 306
ILLUSTRATIVE FIGURES......Page 307
MRI of Liver T umors After T reatment......Page 338
Interpreting Post-Operative Anatomy......Page 339
Fibrosis......Page 340
Signal Intensity Changes......Page 341
T umor Response......Page 342
Cyst or T umor?......Page 343
REFERENCES......Page 344
Liver MRI for Biliary Obstruction......Page 368
Hilar Cholangiocarcinoma and Its Mimics......Page 370
CLINICAL PRESENTATION......Page 371
MRI TECHNIQUES......Page 372
APPEARANCES ON MRI......Page 373
REFERENCES......Page 374
Some Unsolved Problems in Liver Imaging......Page 398
Improving Contrast Resolution......Page 399
The Problem of Specificity......Page 400
SMALL HYPERVASCULAR NODULES IN THE CIRRHOTIC LIVER......Page 401
Small Hypervascular Nodules in Cirrhosis......Page 402
Index......Page 404