Multinodular focal fatty infiltration of the liver: atypical imaging findings on delayed T1-weighted Gd-BOPTA-enhanced liver-specific MR images.

Published

Journal Article

We report a case of pathologically confirmed multinodular focal fatty infiltration. MRI was performed after bolus injection of gadobenate dimeglumine (Gd-BOPTA, MultiHance; Bracco, Milan, Italy), a liver-specific paramagnetic, gadolinium (Gd)-based MR contrast agent that concomitantly enables the acquisition of a standard dynamic phase with timing strategies similar to those used for other extracellular fluid contrast agents, followed by a delayed T1-weighted liver-specific phase (the so-called hepatobiliary phase). In the present case, multiple rounded areas of fatty infiltration, although confidently diagnosed using chemical shift sequences due to a significant signal intensity reduction on out-of-phase images, were unexpectedly hypointense during the delayed liver-specific phase of Gd-BOPTA. Reduced Gd-BOPTA concentration during the liver-specific phase is generally correlated with liver malignancy. Since such lesions can be prospectively mistaken for metastatic disease, we performed a hepatic biopsy to establish a definitive diagnosis. Our empirical observations suggest that Gd-BOPTA uptake may be impaired in fatty infiltrated liver tissue. Because at present there is no report evaluating the kinetics of Gd-BOPTA in fatty liver, further studies are needed to specifically investigate this issue.

Full Text

Duke Authors

Cited Authors

  • Marin, D; Iannaccone, R; Catalano, C; Passariello, R

Published Date

  • September 2006

Published In

Volume / Issue

  • 24 / 3

Start / End Page

  • 690 - 694

PubMed ID

  • 16878304

Pubmed Central ID

  • 16878304

International Standard Serial Number (ISSN)

  • 1053-1807

Digital Object Identifier (DOI)

  • 10.1002/jmri.20660

Language

  • eng

Conference Location

  • United States