Aged ; Aged, 80 and over ; Contrast Media* ; Diffusion Magnetic Resonance Imaging ; Eosinophilia/diagnosis* ; Female ; Gadolinium DTPA* ; Humans ; Image Interpretation, Computer-Assisted ; Liver Diseases/diagnosis* ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Retrospective Studies
Keywords
eosinophil l ; liver ; magnetic resonance imaging ; gadolinium-ethoxybenzyl-DTPA ; diffusion-weighted image
Abstract
OBJECTIVES: Using gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI), the purpose of this study was to evaluate findings of focal hepatic eosinophilic infiltration.
METHODS: This retrospective study included 8 patients with 7 histologically confirmed focal eosinophilic infiltration (FEI) of the liver. One case was considered as FEI by using clinical findings and follow-up imaging. Gadoxetic acid-enhanced MRI and DWI were reviewed by 2 radiologists. We evaluated the signal intensity of focal lesions on T1-weighted, T2-weighted, and DW images and the pattern of enhancement in arterial, portal, equilibrium, and hepatobiliary phases of the gadoxetic acid-enhanced MRI. Apparent diffusion coefficient (ADC) value for focal eosinophilic infiltration was also calculated.
RESULTS: On T2-weighted images, 7 (88%) of 8 cases (7/8 lesions) showed mixed hyperintensity with irregular margins. Six (75%) of the 8 cases showed rim enhancement in the arterial phase. Most cases (5/8 lesions [63%]) showed isointensity or hypointensity in the portal and equilibrium phases. In the hepatobiliary phase, all cases (8/8) showed mixed hypointensity with irregular margins and nonspherical shapes. All cases showed hyperintensity in both low and high b-value ranges on DWI. The ADCs for 6 cases showed less than 1.05 × 10(-3) mm2/s (0.74 × 10(-3) to 1.03 × 10(-3) mm2/s).
CONCLUSIONS: Focal eosinophilic infiltration showed mixed hypointensity, irregular margins, and nonspherical shapes with excellent lesion-to-liver contrast in the hepatobiliary phase of the gadoxetic acid-enhanced MRI. Diffusion-weighted imaging and ADCs may not be helpful for characterizing these benign hepatic lesions.