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This next patient is a 25-year-old female who

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had an indeterminate mass in the liver, seen on a

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prior imaging study for which an MRI was requested.

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And because there was some thought that this lesion could

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reflect focal nodule or hyperplasia, or potentially a

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liver adenoma, we decided to do this with an intravenous

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contrast agent, which is Eovist, that allows us to

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potentially differentiate between these two entities.

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So, we'll start off our evaluation

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looking at our T2-weighted images.

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As we scroll through these images, we can see a

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rather sizable mass within the left hepatic lobe.

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On the T2-weighted images performed without fat

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saturation, we can see the lesion over here.

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The signal intensity is slightly hyper

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intense with respect to the liver parenchyma.

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On the T2-weighted images performed with fat saturation,

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it redemonstrates that slightly hyperintense T2

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signal, and internally within it, we can see that

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there is a cleft-like region of even brighter signal.

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This signal almost looks very, very similar to CSF.

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So quite bright signal seen on the central

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aspect of this lesion on our T2-weighted images.

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Next up, we're going to look at

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our T1 in and out of phase images.

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As we scroll through Once again, we can

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see this lesion in the left hepatic lobe.

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The out-of-phase image over here,

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lesion is pretty difficult to see.

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The most part looks pretty isointense

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with respect to the liver parenchyma.

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On the in-phase image over here, again,

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quite challenging to see this lesion.

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Maybe iso to slightly hypointense

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with respect to the liver parenchyma.

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That cleft-like region, a very bright signal, is

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quite dark on the T1 in and out of phase images.

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There's no evidence that this contains fat or any

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sort of content that causes increased susceptibility.

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The next image we need to look at

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is our T1 fat sat precontrast image.

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a little bit challenging to clearly delineate.

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Knowing where it is based on the other sequences, we know

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that it's probably going to be this lesion seen over here.

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Overall signal intensity is ISO to slightly hypo

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intense with respect to the liver parenchyma.

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Those cleft-like regions over here are more, uh,

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discreetly hypo intense on the T1-weighted images.

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Next up, we need to see how this lesion enhances.

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So here we have some post-contrast images.

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Demonstrating the lesion indeed does enhance.

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On the arterial phase image, overall enhancement

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is pretty homogeneous except for that central

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cleft-like region which doesn't enhance.

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And, on our portal venous phase image, we can see that

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the lesion remains hyper intense with respect to the liver

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parenchyma; however, it's becoming increasingly iso intense.

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That is, it looks more similar to the liver parenchyma on

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the portal venous phase than it did on the arterial phase.

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As mentioned earlier, we did perform this study with, uh,

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EOVIST to see if we can characterize this and potentially

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differentiate it from other entities such as liver adenomas.

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So, next up, we'll evaluate the, uh, 20 minutes.

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Post-contrast EOVIST image.

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So, evaluation with EOVIST.

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We can again see this mass that is predominantly

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hyper intense, brighter than the adjacent liver

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parenchyma, especially around these portions over here.

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And so, this is what it looks

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like in the arterial phase image.

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Once again, it has that arterial hyper enhancement.

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Uh, on the portal venous phase images, as you recall,

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it became more iso intense with respect to the liver.

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On the EOVIST 20-minute phase images, it became

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It is, uh, for the most part, hyper intense.

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This is another example of focal nodular hyperplasia.

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That central portion within this, which was T2,

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hyper intense, does not enhance on the arterial

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phase images, and when we image at 20 minutes, it

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also remains hypo intense on that phase as well.