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Focal Eosinophilic Infiltration of the Liver: Gadoxetic Acid-Enhanced Magnetic Resonance Imaging and Diffusion-Weighted Imaging

Ahn, Sung Jun MD; Choi, Jin-Young MD; Kim, Kyung Ah MD; Kim, Myeong-Jin MD; Baek, Song-Ee MD; Kim, Joo Hee MD; Song, Ho-Taek MD, PhD

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3181f39f30
Original Articles
Abstract

Objectives: Using gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI), the purpose of this study was to evaluate findings of focal hepatic eosinophilic infiltration.

Methods: This retrospective study included 8 patients with 7 histologically confirmed focal eosinophilic infiltration (FEI) of the liver. One case was considered as FEI by using clinical findings and follow-up imaging. Gadoxetic acid-enhanced MRI and DWI were reviewed by 2 radiologists. We evaluated the signal intensity of focal lesions on T1-weighted, T2-weighted, and DW images and the pattern of enhancement in arterial, portal, equilibrium, and hepatobiliary phases of the gadoxetic acid-enhanced MRI. Apparent diffusion coefficient (ADC) value for focal eosinophilic infiltration was also calculated.

Results: On T2-weighted images, 7 (88%) of 8 cases (7/8 lesions) showed mixed hyperintensity with irregular margins. Six (75%) of the 8 cases showed rim enhancement in the arterial phase. Most cases (5/8 lesions [63%]) showed isointensity or hypointensity in the portal and equilibrium phases. In the hepatobiliary phase, all cases (8/8) showed mixed hypointensity with irregular margins and nonspherical shapes. All cases showed hyperintensity in both low and high b-value ranges on DWI. The ADCs for 6 cases showed less than 1.05 × 10−3 mm2/s (0.74 × 10−3 to 1.03 × 10−3 mm2/s).

Conclusions: Focal eosinophilic infiltration showed mixed hypointensity, irregular margins, and nonspherical shapes with excellent lesion-to-liver contrast in the hepatobiliary phase of the gadoxetic acid-enhanced MRI. Diffusion-weighted imaging and ADCs may not be helpful for characterizing these benign hepatic lesions.

Author Information

From the *Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System; †Institute of Gastroenterology, Yonsei University College of Medicine, Seoul; and ‡Department of Radiology, Inje University Ilsan-Paik Hospital, Goyang, Korea.

Received for publication April 21, 2010; accepted July 8, 2010.

Reprints: Jin-Young Choi, MD, Department of Radiology, Yonsei University Health System, Seodaemun-ku Shinchon-dong 134, Seoul 120-752, Republic of Korea (e-mail: gafield2@yuhs.ac).

This study was supported by a faculty research grant of Yonsei University College of Medicine for 2009 (0166).

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