LI-RADS M lesion

Case contributed by Luu Hanh
Diagnosis almost certain


HBsAg positive

Patient Data

Age: 70 years
Gender: Male

The liver shows heterogeneous signal, marginal irregularity, with multiple parenchymal nodules in keeping with cirrhosis.

The multiple innumerable nodules in both liver lobes show a hyperintense signal on T1, an isointense signal on T2 compatible with the dysplastic/regenerative nodules.

The observation in segment 8 of the liver presents a high signal on T2, ring enhancement on arterial phase, progressive fill and without washout on delayed phase.

There is no portal vein thrombosis.

Annotated image

Yellow arrow: the observation in the segment 8

Case Discussion

The observation in segment 8 does not have the typical characteristics of HCC, which was classified as LR-M - malignant.

LI-RADS is the classification system meant to be used in livers with risk factors for HCC. LR-M for liver lesions that are probably or definitely malignant but not an appearance compatible with HCC, which either show: 

  • targetoid mass
  • non-targetoid mass with infiltrative appearance, marked diffusion restriction, necrosis or severe ischemia.

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