Differential Diagnosis of Liver Metastases and Hemangiomas Through Diffusion Weighted MR Imaging

This paper aims to analyze the role of diffusion-weighted MR imaging and ADC map in the differential diagnosis of liver metastases and hemangiomas in patients with liver lesions.

From April 2017 to September 2018, 30 patients (21 females and 9 males) aged 32–81 years old (mean age of 53.01±13.01) with 43 lesions were diagnosed with lesions classified as either metastases or hepatic hemangiomas in the abdominal area by ultrasound or CT scan. They were then referred to an MRI department for further diagnosis. Moreover, the DWI sequence was performed with respiratory gating with b-values of 50, 500, 1000, and 1500 s/mm2. The research group was divided into two subgroups: atypical haemangiomas and hypo- and hypervascular metastases. The mean values of ADC, ADCR, SIR, and SI were calculated. Similarly, cut-off values, sensitivity, and specificity were calculated with ROC curve analysis.

There was a significant difference between hemangioma and metastatic lesions in terms of mean ADC (P<0.01), mean ADCR (P<0.01), SIR at a b-value of 50 s/mm2 (P<0.01), SI at b-values of 50 and 500 s/mm2 (P<0.05), and SIR at a b-value of 500 s/mm2 (P<0.05). There was also a clear distinction between the two groups of hypo- and hypervascular metastases in terms of SIR at a b-value of 1500 s/mm2 (P<0.01) and SIR at b-values of 50, 500, and 1000 s/mm2 (P<0.05).

DWI-MRI and ADC map can be used to reliably differentiate between hemangiomas and metastases in the liver with higher accuracy, sensitivity, and specificity.