Liver MRI Study Notes – Typical Small Cysts

  Hepatic cysts are congenital, non-genetic intrahepatic cystic lesions. The cystic cavity usually does not communicate with the intrahepatic bile duct system, and the cyst is a closed cavity consisting of an arrangement of epithelial cells containing fluid, which can be solitary or multiple. Solitary belongs to one of the main types of hepatic cysts. It is generally considered to be a stagnant cyst originating from the vagal bile ducts in the liver and is a congenital developmental anomaly. Liver cysts grow slowly and most patients have no obvious symptoms and are only discovered incidentally during physical examination. Large hepatic cysts may present with significant compression symptoms. If combined with infection, symptoms similar to liver abscess may appear such as chills, fever and abdominal pain. Small cysts (less than 10mm) are sometimes difficult to distinguish from metastases, especially combined with liver metastases such as gastrointestinal metastases.  MRI manifestation】 The boundary is clear. T1WI low signal, T2WI high signal, gadolinium contrast enhancement early and late as well as delayed period is always non-enhancing.  A: T2 fat suppression: high signal, “light bulb sign”; B: T1 isophase: very low signal relative to the liver; C. T1 enhancement imaging: no enhancement; D. Delayed phase: no enhancement.  Pathological manifestations】 Showing naked epithelial cells, cystic cavity, and intracavity with hemorrhage.  Differential diagnosis】 Simple hepatic cysts are not difficult to diagnose; with compartmentalized cysts need to be differentiated from mucinous or cystic metastases.