Introduction
Multiphasic contrast enhanced MRI is the reference standard for characterizing focal liver lesions and staging hepatocellular carcinoma. Hepatobiliary specific contrast agents provide additional lesion characterization by assessing hepatocyte function. Diffusion weighted imaging and quantitative mapping complement dynamic sequences.
Protocol Components
Core sequences include T2 weighted imaging diffusion weighted imaging and dynamic T1 weighted phases arterial portal venous and delayed or hepatobiliary phases. Breath hold techniques and antiperistaltic agents improve image quality. Standardized acquisition parameters support reproducible lesion assessment.
Interpretation and Reporting
Reporting should describe lesion size enhancement pattern diffusion characteristics and hepatobiliary uptake with clear management recommendations. Use of LI RADS or other standardized lexicons improves communication for HCC surveillance and treatment planning. Correlation with clinical history and laboratory data is essential.
Clinical Impact
Accurate MRI characterization guides decisions about biopsy resection ablation or transplantation and reduces unnecessary procedures. Quantitative imaging biomarkers support monitoring of treatment response in oncology trials. Multidisciplinary collaboration ensures optimal patient management.