MRI manifestations of hepatic perfusion disorders

Abstract

The present study aimed to analyze the magnetic resonance imaging (MRI) results from patients with hepatic perfusion disorders (HPD) and liver diseases, in order to assess the pathogenetic mechanisms. This was completed byanalyzing the causes of HPD in 35 patients to assess if they were associated with arterioportal shunt, and classify the patients according to results from the MRI scans. Of the 35 patients, 26 (74.3%) with HPD presented with hepatocellular carcinoma, a major cause of HPD. The HPD phenomenon in 35 patients was not identified as obvious abnormal lesions on T2WI and T1WI according to the isointensity on diffusion weighted images. Enhanced scanning showed hyperintense signals on the arterial phase images, isointense or hyperintense signals on portal phase and delayed phase images. According to their MRI findings, hepatic perfusion disorders may be divided into different types, as follows: Diffuse, lobe or segment type, wedge type and platy. The HPD phenomenon may herald an underlying abnormality of liver disease and MRI may accurately diagnose HPDs in liver diseases.

Keywords: disorders; hepatic; magnetic resonance imaging; perfusion.

Figure 1.

Surrounding liver tissue perfusion disorders caused by liver cancer of a male, aged 62, with history of hepatitis B. White arrow in each panel indicated the tumor in the liver. (A) Imaging in the arterial phase was significantly enhanced. (B) Imaging in the venous phase is slightly hyperintense. (C) Imaging in the delayed phase indicates hypointense signals. Biopsy reveals liver cell adenocarcinoma and abnormal perfusion in the liver inferior to the adjacent region. (D) Imaging in the arterial phase was hyperintense. (E) Imaging in the venous phase and (F) delayed phase is slightly hyperintense.

Figure 2.

Case of liver tissue perfusion disorder caused by cholecystitis in a male aged 70, with history of cholecystitis and hepatic perfusion disorder. The upper and lower white arrows in each panel indicate the two hepatic perfusion disorder areas, which were all liver lobe-liver segment type. Liver enhanced imaging (A) in the arterial phase indicates multiple abnormal enhancements in the left and right lobe of the liver with clear boundaries. (B) Imaging in the portal phase and (C) delayed phase was slightly hyperintense.