Assessment of low signal adjacent to the falciform ligament on contrast-enhanced MRI

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Michael Macari1, Rita Yeretsian, James Babb

  • 1Department of Radiology, Abdominal Imaging, New York University School of Medicine, Tisch Hospital, 560 First Ave., Ste. HW 202, New York, NY 10016, USA. michael.macari@nyumc.org

AJR. American Journal of Roentgenology
|November 22, 2007
PubMed
Abstract

Insights

Geographic low signal near the falciform ligament on MRI is often mistaken for fatty infiltration. This study found it typically represents anomalous venous drainage, not focal fat.

Area of Science:

  • Radiology
  • Medical Imaging
  • Hepatology

Background:

  • Geographic low signal in the medial liver segment on contrast-enhanced MRI is commonly attributed to focal fatty infiltration.
  • This finding is often observed adjacent to the falciform ligament.

Purpose of the Study:

  • To investigate whether geographic low signal in the medial liver segment on contrast-enhanced MRI represents focal fatty infiltration.
  • To differentiate focal fatty infiltration from other causes using in- and opposed-phase gradient-recalled echo (GRE) T1-weighted MRI.

Main Methods:

  • Reviewed contrast-enhanced abdominal MRI scans of 121 patients without diffuse liver disease.
  • Assessed for geographic low signal adjacent to the falciform ligament during dynamic gadolinium-enhanced imaging.
  • Evaluated in- and opposed-phase GRE T1-weighted images for signal loss to determine the presence of focal fat.

Main Results:

  • Twenty-one patients (17.4%) exhibited focal low signal adjacent to the falciform ligament.
  • This finding was consistently present during the portal venous phase.
  • Only three patients showed signal loss on opposed-phase imaging, suggesting it is not typically focal fat.

Conclusions:

  • Geographic low signal adjacent to the falciform ligament on contrast-enhanced MRI is usually not focal fatty infiltration.
  • Anomalous venous drainage into the liver is a more likely cause for this imaging finding.
  • In- and opposed-phase MRI can help differentiate causes of focal liver signal abnormalities.

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