CT and MRI of diffuse lobar involvement pattern in liver pathology

Area of Science:

• Radiology
• Hepatology
• Medical Imaging

Background:

• Liver pathologies are typically described as focal, segmental, or diffuse.
• A distinct pattern of liver pathology confined to a single lobe has not been previously documented in the literature.

Purpose of the Study:

• To describe a novel pattern of diffuse lobar liver pathology.
• To illustrate computed tomography (CT) and magnetic resonance imaging (MRI) findings associated with this lobar pattern.
• To discuss the diagnostic challenges and utility of MRI in evaluating lobar liver pathologies.

Main Methods:

• Review and illustration of CT and MRI findings in patients with diffuse lobar liver involvement.
• Analysis of imaging characteristics across various benign and malignant liver conditions exhibiting a lobar pattern.
• Discussion of the role of in- and out-of-phase MRI in assessing fat accumulation within the lobe.

Main Results:

• Diffuse lobar involvement is demonstrated in various benign conditions including steatosis, iron overload, cholestasis, perfusion alterations, infarction, hydatid cysts, trauma, and hemangiomas.
• Primary malignant pathology, specifically hepatocellular carcinoma, can present with a diffuse lobar pattern.
• Diffuse lobar involvement in metastatic liver disease appears to be rare.

Conclusions:

• A lobar pattern of liver pathology, previously undescribed, is presented with characteristic CT and MRI findings.
• This lobar pattern can manifest in a wide spectrum of benign and primary malignant liver diseases, posing potential diagnostic challenges.
• Liver MRI serves as a valuable problem-solving tool for diffuse lobar pathologies, with specific sequences aiding in fat assessment.