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Hepatitis, cirrhosis, and hepatoma
T Murakami1, T Kim, H Nakamura
1Department of Radiology, Toyonaka Municipal Hospital, Osaka, Japan.
Insights
Hepatitis and liver cirrhosis, common in Asia, often lead to liver cancer (HCC). Magnetic Resonance Imaging (MRI) aids in diagnosing these conditions and HCC by revealing specific tissue characteristics.
Area of Science:
- Hepatology
- Medical Imaging
- Oncology
Background:
- Virus hepatitis and liver cirrhosis are prevalent in Asia.
- These conditions frequently complicate with hepatocellular carcinoma (HCC).
- Accurate diagnosis of diffuse liver diseases requires biochemical and imaging assessments.
Purpose of the Study:
- To elucidate the specific appearances of hepatitis, liver cirrhosis, and HCC on MRI.
- To highlight the importance of MRI in diagnosing diffuse liver diseases.
- To assess MRI's utility in evaluating treatment effects for HCC.
Main Methods:
- Utilizing T2-weighted spin echo and gradient echo MRI sequences.
- Analyzing signal intensities to differentiate between necrosis, regeneration, and fibrosis.
- Employing dynamic MRI for HCC visualization and assessment.
Main Results:
- Severe hepatitis shows high intensity on T2-weighted images; regeneration appears as low intensity.
- Cirrhotic changes, including fibrotic septa and regenerating nodules, exhibit distinct signal characteristics.
- Gradient echo images identify iron deposition in nodules.
- Dynamic MRI effectively visualizes and diagnoses HCC, aiding in treatment evaluation.
Conclusions:
- MRI provides crucial insights into the morphology and pathology of hepatitis and liver cirrhosis.
- MRI is a valuable, less invasive tool for objective diagnosis and functional evaluation of diffuse liver diseases.
- Dynamic MRI is highly effective for HCC diagnosis and monitoring treatment response.
Abstract:
Virus hepatitis and liver cirrhosis are found at high incidence in Asia, and they require not only biochemical examination of blood but also subsequent imaging, because they are often complicated by hepatocellular carcinoma (HCC). It is, therefore, very important to know the specific appearances of hepatitis, liver cirrhosis, and HCC when we diagnose these diffuse liver diseases. Liver necrosis due to severe hepatitis is seen as high intensity on T2-weighted spin echo images. Regeneration is seen as low intensity on T2-weighted images. Morphologic and pathologic changes of cirrhotic liver are well demonstrated by MR imaging techniques. Fibrotic septum with inflammatory cell infiltration or rich pseudo bile duct show high intensity on T2-weighted images, and regenerating nodules shows low intensity. Gradient echo images show regenerating nodules with iron deposition as low-intensity nodules due to susceptibility artifact. MRI also has the potential to evaluate function of diffuse liver disease, cirrhosis, and hepatitis. MRI can visualize and diagnose HCC objectively. Dynamic MRI is very useful for diagnosing HCC. It is also applied for evaluation of effect after transcatheter arterial chemoembolization, because it shows enhancement only in the viable region at an arterial phase. MRI is less invasive and is thus an extremely important form of liver imaging.