MRI
Axial T2 fat sat
Axial T1
Axial T1 C+ fat sat arterial
Axial T1 C+ fat sat delayed
Name 5 different arterially enhancing liver lesions.
1. Hepatocellular carcinoma (rapid washout). 2. Hepatic haemangioma (progressive fill in). 3. Focal nodular hyperplasia (becoming isointense / isodense during portal venous phase, non-enhancing or delayed enhancing central scar). 4 Hepatic adenoma (becoming isointense / isodense during portal venous phase). 5. Hypervascular metastases (renal cell carcinoma, thyroid carcinoma, neuroendocrine tumours, melanoma, breast cancer).
Two nodular lesions are observed in liver segments VII and VIII. Both are invisible on T2. The larger one has a hypointense rim on T1. Both enhance during the arterial phase and wash out centrally on the more delayed images consistent with hepatocellular carcinoma in a patient with cirrhosis. There are also some periportal cysts. The dark ring with central enhancement on the T1-weighted images is the TIPS stent (red arrow on the annotated image).