Benign focal liver lesions: The role of magnetic resonance imaging

Figure 13  An 80-year-old patient with the finding of common hepatic bile duct stenosis. Cholangiography procedure with the placement of biliary drainage in which histological diagnosis of the biliary tract suggested adenocarcinoma of the main biliary duct. Following an episode of fever, increase in white blood cells (13.02 × 10^-9/L) and C-reactive protein (90.1 mg/L) computed tomography examination showed a small hepatic hypodensity in the 7^th segment. Liver magnetic resonance imaging (MRI) performed after a few days of therapy shows a nodular lesion, hypointense on the T1-weighted sequences, slightly hyperintense in the T2 sequences, with increased signal on diffusion weighted imaging (DWI) and hypointense signal on the hepatobiliary phase. A 7-d follow-up liver MRI examination showed a further evolution of the lesion with evidence of a very slight hyperintense signal on T2 sequences and almost disappearance of the lesion itself on DWI, which confirmed the diagnosis of hepatic abscess. A: Percutaneous transhepatic cholangiography; B: Portal venous phase of liver computed tomography (CT); C: Delayed phase of liver CT; D: In-phase T1-weighted image; E: Out-of-phase T1-weighted image; F: T2-weighted image; G: T2-Spectral Attenuated Inversion Recovery (SPAIR); H: High b-value diffusion weighted imaging; I: Hepatobiliary phase magnetic resonance imaging; L: T2-weighted image; M: T2-SPAIR; N: high b-value DWI.