1. LIVER MRI Kyung Hee University Hospital Hyoung Jung Kim
Department of Diagnostic Radiology,
Kyung Hee University Hospital

3. MRI signal: Concept of Relaxation
RF pulse
T1 relaxation TR
Tissue의 T1 value
T2 relaxation TE
Tissue의 T2 value

5. Routine Sequence of liver MRI in KMC
Indications of Liver MRI
Lesion characterization
T2WI vs. heavily T2WI
T1WI
Dynamic enhanced image
liver-specific contrast agent
Lesion detection
too small to characterize
Limitations of liver MRI
3T MRI in hepatobiliary and GI tract

6. Routine Sequence of liver MRI in KMC

8. Pre
Arterial
Portal
Delay

9. Indications of Liver MRI Lesion characterization T2WI vs. heavily T2WI

12. Ref)
1. Hayashi M, Matsui O, Ueda K, et al. Correlation between the blood supply and grade of malignancy of hepatocellular nodules associaed with liver cirrhosis: evaluation by during intraarterial injection of contrast medium. AJR 1999; 172:
2. Krinsky GA, Lee VS. MR imaging of cirrhotic nodules. Abdom Imaging 2000;25:

13. FU after 6 months

14. Indications of Liver MRI Lesion characterization T1WI
Out of phase In phase

16. Indications of Liver MRI. Lesion characterization
Indications of Liver MRI Lesion characterization Dynamic enhanced image

19. Indications of Liver MRI. Lesion characterization
Indications of Liver MRI Lesion characterization Liver-specific contrast agent

20. - Liver MRI is helpful in the characterization of hepatic lesions.
Take home message #1:
- Liver MRI is helpful in the characterization of hepatic lesions.
T2WI & Heavily T2WI: cyst, hemangioma vs. HCC, meta
Dual echo T1WI: focal fatty infiltration or sparing, adenoma
Liver specific contrast agent: FNH
Take home message #2:
- Liver MRI may show more prominent tumor enhancement than dynamic CT.
Partial lipiodolized HCC

21. Indications of Liver MRI Lesion detection too small to characterize

22. Indications of Liver MRI. Lesion detection
Indications of Liver MRI Lesion detection Liver-specific contrast agent
Post 10 min T1

25. - Hepatic metastasis is a good candidate for liver MRI.
Take home message #3:
- Hepatic metastasis is a good candidate for liver MRI.
; candidate of tumorectomy for the known hepatic metastases
; increased tumor marker and no evidence recurrence on CT
; liver specific contrast agent may be helpful in the detection of small hepatic metastasis.

26. Limitations of Liver MRI - I

27. Focal eosinophilic necrosis_gross specimen

28. Limitations of Liver MRI - II
Post 10 min T2

30. 3T MRI in hepatobiliary and GI tract - 3D THRIVE

31. Sagittal Coronal Axial
- 3D VISTA(Volumetric ISotropic T2W Acquisition)
VISTA
Sagittal Coronal Axial

32. - DWI (diffusion weighted image)

33. Thank you for your attention!