Typical and atypical liver hemangiomas… Can diffusion MR with different b values provide confident diagnosis?

The aim of this work was to evaluate the ability of Diffusion MRI using different b values in detection and characterization of liver hemangiomas in order to differentiate them from other focal hepatic lesions.Patients and methodsThirty one hemangiomas in 28 patients were examined with diffusion MR using different four b values: 200, 500, 800 and 1000 s/mm2. Hemangiomas were divided into typical and atypical lesions. Lesions were evaluated regarding size, enhancement pattern, signal intensity and ADC maps in conventional and diffusion MR.ResultsAll hemangiomas showed hyperintense signal at diffusion MR with different b values. In typical and atypical hemangiomas, diffusion MR showed hyperintense signal that persisted with increasing b values. Both types showed hyperintense signal or mixed signals in ADC maps. Mean ADC values (for both types) were 2.47, 2.36, 2.31 and 2.10 × 10−3 mm2/s for b 200, 500, 800 and 1000, respectively. Arterial nodular enhancement pattern of atypical hemangiomas showed significant increased ADC value than other types.ConclusionDWI can successfully detect and characterize hepatic hemangiomas, it provides qualitative and quantitative assessment of hemangiomas. The combination of diffusion signal intensity and ADC maps and values successfully differentiates hemangiomas from other focal lesions rather than signal intensity changes in different b values.