MRI Findings of Focal Eosinophilic Liver Diseases
Young-Kon Kim1,
Chong Soo Kim1,
Woo Sung Moon2,
Baik-Hwan Cho3,
Sang Yong Lee1 and
Jeong Min Lee4
1 Department of Diagnostic Radiology, Chonbuk National University Hospital,
Chonju, Korea.
2 Department of Pathology, Chonbuk National University Hospital, Chonju,
Korea.
3 Department of General Surgery, Chonbuk National University Hospital, Chonju,
Korea.
4 Department of Radiology and Institute of Radiation Medicine, Seoul National
University Hospital and College of Medicine, 28, Yongon-dong, Chongno-gu,
Seoul 110-744, South Korea.
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Fig. 1A. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. Respiratory-triggered
T2-weighted turbo spin-echo image shows 3-cm-diameter hyperintense nodule
(arrow) in left lateral segment of liver.
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Fig. 1B. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. Respiratory-triggered
T2-weighted turbo spin-echo image obtained at slightly higher level than
A shows another small, slightly hyperintense nodule (arrow)
considered to be daughter nodule.
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Fig. 1C. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. On dynamic arterial
phase image obtained after administration of gadobenate dimeglumine, nodule
(arrow) in hepatic segment II shows strong nodular enhancement.
Nodule was confirmed as hepatocellular carcinoma.
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Fig. 1D. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. On dynamic arterial
phase image, second nodule (arrow) (seen on B) also shows
nodular enhancement.
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Fig. 1E. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. On equilibrium phase
image obtained 3 min after contrast injection, main mass (arrow)
shows low signal intensity with capsular enhancement.
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Fig. 1F. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. On equilibrium phase
image, second nodule (seen on B and D) becomes isointense
compared with surrounding liver parenchyma.
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Fig. 1G. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. Photograph of gross
specimen shows both nodular hepatocellular carcinoma (large arrow)
and eosinophilic abscess (small arrow) in same hepatic segment.
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Fig. 1H. —48-year-old man with nodular hepatocellular carcinoma and
eosinophilic abscess in left lateral segment of liver. Photomicrograph of
specimen (indicated by small arrow in G) obtained at surgery
shows that normal hepatocytes are replaced by numerous inflammatory cell
infiltrates predominantly composed of eosinophils (arrows). (H and E,
x150)
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Fig. 2A. —55-year-old man with multifocal eosinophilic infiltrations in
liver. T1-weighted gradient-echo image shows focal faintly low signal
intensities in subcapsular area (arrow) of right hepatic lobe.
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Fig. 2B. —55-year-old man with multifocal eosinophilic infiltrations in
liver. Respiratory-triggered T2-weighted turbo spin-echo image shows poorly
defined faint hyperintensity (arrow) at same location as in
A.
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Fig. 2C. —55-year-old man with multifocal eosinophilic infiltrations in
liver. Gadolinium-enhanced dynamic portal phase image shows irregularly low
signal intensities (arrow) at same location as in A and
B.
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Fig. 2D. —55-year-old man with multifocal eosinophilic infiltrations in
liver. Superparamagnetic iron oxide–enhanced breath-hold T2*-weighted
fast image obtained with steady-state procession shows poorly defined focal
hyperintense lesion (arrow). Conspicuity of lesion is remarkably
improved compared with that seen on unenhanced images (A and
B).
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Fig. 2E. —55-year-old man with multifocal eosinophilic infiltrations in
liver. Photomicrograph of needle biopsy specimen shows numerous inflammatory
cell infiltrates predominantly composed of eosinophils (small arrows)
in periportal area. Large arrows indicate portal triad. (H and E,
x100)
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Fig. 3A. —50-year-old man with multifocal eosinophilic infiltrations in
liver. T1-weighted gradient-echo image shows multiple poorly defined, subtle
low signal intensities (arrows).
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Fig. 3B. —50-year-old man with multifocal eosinophilic infiltrations in
liver. Respiratory-triggered T2-weighted turbo spin-echo image shows poorly
defined, irregularly shaped, faintly high signal intensities (arrows)
in subcapsular region.
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Fig. 3C. —50-year-old man with multifocal eosinophilic infiltrations in
liver. Dynamic arterial phase image does not depict any hepatic lesions.
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Fig. 3D. —50-year-old man with multifocal eosinophilic infiltrations in
liver. Dynamic portal phase image shows bizarrely or irregularly shaped low
signal intensities (arrows).
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Fig. 3E. —50-year-old man with multifocal eosinophilic infiltrations in
liver. Dynamic equilibrium phase image shows no visible lesions because of
slow enhancement of lesions.
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Fig. 4A. —44-year-old man with hepatocellular carcinoma (not shown) and
single eosinophilic abscess. Respiratory-triggered T2-weighted turbo spin-echo
image shows nodular slightly high-signal-intensity lesion (arrow) in
right lobe.
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Fig. 4B. —44-year-old man with hepatocellular carcinoma (not shown) and
single eosinophilic abscess. Lesion (arrow) is not clearly depicted
on T1-weighted gradient-echo MR image.
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Fig. 4C. —44-year-old man with hepatocellular carcinoma (not shown) and
single eosinophilic abscess. On dynamic arterial phase image obtained after
administration of gadobenate dimeglumine, lesion shows bright nodular
enhancement with well-defined margin (arrow).
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Fig. 4D. —44-year-old man with hepatocellular carcinoma (not shown) and
single eosinophilic abscess. On dynamic equilibrium phase image, lesion is
shown as isointense compared with surrounding liver parenchyma.
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Copyright © 2005 by the American Roentgen Ray Society.
