Evaluation of the Role of MRI in diagnosis of Hepatic Focal Lesions in Ahmadu Bello University Teaching Hospital, Zaria Nigeria

Introduction:

Focal liver disease is a common diagnostic problem referred to radiologists for evaluation owing to its nonspecific clinical presentation and marked inter-observer variation on clinical examination. Hepatic focal lesions (HFLs) are classified into benign and malignant lesions. Hemangiomas are the commonest benign tumor while hepatocellular carcinoma (HCC) it is the commonest primary malignant liver tumor. HCC is the fifth most common cancer in the world and the third most frequent cause of death amongst oncological patients.Aim: The present study was to evaluate the role of MRI in the diagnosis of Hepatic Focal lesions.Materials and methods: This study will be conducted on in-patients and out-patients of Ahmadu Bello University Teaching Hospital (ABUTH) Zaria, Kaduna State from March 2023 to June 2023. A total sample of fifty patients will be selected for the present study were in the age group of 18 to 80 years. Clinical features, laboratory tests findings and histopathological findings of the patients will be noted for correlation. MRI will be done for all the patients.Results: This study included 50 patients in total, 29 male and 21 female patients, in age group of 18 to 80 years with a mean age of 48 years. Metastasis and Hepatocellular Carcinoma (HCC) were most common malignant lesions in liver while Hemangiomas were most common benign lesions followed by simple and complex cysts and hepatic adenoma. The present study calculated the specificity and sensitivity of MRI of focal hepatic lesions and correlated the findings clinically, pathologically and histopathologically. The specificity of MRI for characterisation of focal liver disease was high (90.4%). Specificity of MRI for HCC was found to be 96.7 % and that for metastasis was 97% while sensitivity for Haemangiomas is found to be 100%. MRI is superior compared to other modalities like ultrasound and CT in having high spatial resolution. Multiple sequences like T1, T2 and fat suppression techniques like IN PHASE, OUT OF PHASE helps in demonstrating lesion characters like architecture, margin, haemorrhage, fat component and vascular invasion of the lesions.Conclusion: MRI is valuable for the characterization of focal liver lesions detected on Ultrasonography. Basic MRI sequences along with chemical shift imaging sequences and dynamic contrast imaging has significant role in characterising the focal liver lesions. Despite that, it should be the modality choice for the lesions which are undetected or doubtful on ultrasound and CT examinations.