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Indeterminate observations (liver imaging reporting and data system category 3) on MRI in the cirrhotic liver: fate

Jin-Young Choi1, Hyun Cheol Cho, Mark Sun

  • 11 Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Republic of Korea.

AJR. American Journal of Roentgenology
|October 24, 2013
PubMed
Abstract

Insights

Indeterminate liver observations (LI-RADS 3) on MRI in cirrhosis patients are often stable pseudolesions. Most hypervascular findings showed no progression, indicating a low risk of hepatocellular carcinoma.

Area of Science:

  • Radiology
  • Hepatology
  • Oncology

Background:

  • Cirrhosis patients have a high risk of hepatocellular carcinoma.
  • Indeterminate liver observations on MRI (LI-RADS 3) require careful evaluation.
  • Distinguishing benign lesions from early-stage cancer is crucial for patient management.

Purpose of the Study:

  • To retrospectively analyze imaging features of LI-RADS 3 observations in cirrhosis patients.
  • To determine the outcomes and progression patterns of these indeterminate lesions.
  • To identify imaging characteristics associated with benign versus malignant findings.

Main Methods:

  • Retrospective review of 69 LI-RADS 3 observations in 52 cirrhosis patients.
  • Analysis of MRI characteristics including location, size, and enhancement patterns.
  • Evaluation of lesion stability or progression based on serial follow-up MRI examinations.

Main Results:

  • Most observations (67%) demonstrated arterial enhancement.
  • The majority of lesions were classified as arterial enhancement with fade-out (59%) or nonhyperenhancing (33%).
  • Only 6% of observations were ultimately diagnosed as hepatocellular carcinoma; 80% remained stable.

Conclusions:

  • Hypervascular pseudolesions are the most frequent cause of indeterminate MRI findings in cirrhosis.
  • Stable imaging characteristics on follow-up MRI suggest a benign etiology for most LI-RADS 3 observations.
  • MRI with hepatobiliary contrast agents aids in characterizing indeterminate liver lesions in cirrhosis.

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