Evaluation of Liver Masses and Accompanying Findings by Diffusion-Weighted Magnetic Resonance Imaging

Objective:The aim of this study was to investigate the contribution of diffusion-weighted magnetic resonance imaging to differential diagnosis in the characterization of liver masses. Methods: Diffusion-weighted sequences were added to conventional sequences in cases in which a mass was detected during upper abdominal magnetic resonance imaging performed for any reason. Diffusion-weighted images were obtained by applying diffusion-sensitive gradients at the b0, b600, and b1000 values with a single shot echo-planar spin echo sequence in the axial plane using the 1.5T magnetic resonance imaging device, and apparent diffusion coefficient maps were automatically constructed from these images by the magnetic resonance imaging device. The mean apparent diffusion coefficient values were calculated for 56 masses and 45 liver parenchyma in 45 cases with histopathological diagnoses. Results: Of the 56 masses, 28 were benign and 28 were malignant. The benign masses consisted of 11 hemangiomas, 8 hydatid cysts, 3 simple cysts, 4 abscesses, and 2 focal nodular hyperplasia. The malignant masses comprised 13 hepatocellular carcinomas, 12 metastases, 2 cholangio cellular carcinomas, and 1 carcinosarcoma. The mean apparent diffusion coefficient value of the benign masses was calculated to be 2.67 x 10(-3) s/mm(2) and that of the apparent diffusion coefficient value was 1.21 x 10(-3) s/mm(2), indicating a statistically significant difference between the 2 groups. Apparent diffusion coefficient combined with diffusion-weighted magnetic resonance imaging had 100% sensitivity and 69% specificity in the differentiation of benign and malignant masses Conclusion: Diffusion-weighted magnetic resonance imaging is a technique that provides results in a short time without using any contrast agent and contributes to the differential diagnosis of liver masses and should be added to conventional sequences.