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Nondefect of Arterial Enhancing Rim on Hepatobiliary Phase in 3.0-T Gadolinium-Ethoxybenzyl-Diethylenetriamine Pentaacetic AcidEnhanced Liver Magnetic Resonance Imaging: Distinguishing Hepatic Abscess from Metastasis

Choi, Seung Hee MD*; Lee, Chang Hee MD, PhD*; Kim, Baek Hui MD; Lee, Jongmee MD*; Choi, Jae Woong MD*; Park, Yang Shin MD*; Kim, Kyeong Ah MD*; Park, Cheol Min MD*

Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e318297211a
Gastrointestinal Imaging
Abstract

Objective: The objective of this study was to retrospectively determine the findings of Gd-EOB-DTPA (gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid)–enhanced magnetic resonance imaging (MRI) to distinguish abscess from metastasis of the liver.

Methods: Among patients who underwent Gd-EOB-DTPA MRI from March 2008 to December 2011, 32 patients with abscess or metastasis were included, and all lesions showed arterial rim enhancement. Twenty-one abscesses and 19 metastases were included. Two radiologists assessed how the arterial enhancing rim showed in hepatobiliary phase (HBP) and classified the signal intensity of the rim into defect zone, gray zone, and uptake zone. The frequency of showing nondefect, which means gray or uptake zone between both lesions, was compared using Pearson χ2 test.

Results: The rim of arterial enhancement in 3 abscesses (14.3%) and 15 metastases (78.9%) showed defect zone in HBP. Six abscesses (28.6%)and no metastases showed gray zone, and 12 abscesses (57.1%) and 4 metastases (21.1%) showed uptake zone. The frequency of nondefect in the rim of arterial enhancement on HBP was significantly higher in abscesses (85.7% of abscesses, 21.1% of metastases, P < 0.001).

Conclusions: A reliable finding that distinguished abscess from metastasis was nondefect of arterial enhancing rim on HBP in Gd-EOB-DTPA MRI. This is a meaningful feature for differentiating abscess from metastasis, especially when evaluating patients with primary malignancy.

Author Information

From the Departments of *Radiology and Pathology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Received for publication March 8, 2013; accepted April 13, 2013.

Reprints: Chang Hee Lee, MD, PhD, Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703, Korea (e-mail: chlee86@hanmail.net).

This study was supported by a Korea University grant (2013).

The authors have no conflicts of interest to declare.

© 2013 by Lippincott Williams & Wilkins