Investig Magn Reson Imaging.  2015 Mar;19(1):52-55. 10.13104/imri.2015.19.1.52.

Supradiaphragmatic Liver Confirmed by a Hepatocyte-specific Contrast Agent (Gd-EOB-DTPA): A Case Report

• Cho YJ
• Kim HJ
• Bae YA
• Jang SK
• Yeon JW

• KMID: 2175577
• DOI: http://doi.org/10.13104/imri.2015.19.1.52

Abstract

Supradiaphragmatic liver is a rare condition. Establishing an accurate preoperative diagnosis is difficult. Operative exploration is necessary to differentiate this lesion from intrathoracic masses, such as a pleural based tumor, diaphragmatic tumor and peripheral lung tumor. However, with the aid of the hepatocyte-specific magnetic resonance imaging contrast agent, gadoxetic acid (Gd-EOB-DTPA), functional hepatocytes in the lesion can be identified in the hepatobiliary phase, potentially allowing an accurate and non-invasive diagnosis. We report a case of supradiaphragmatic liver diagnosed by Gd-EOB-DTPA-enhanced magnetic resonance imaging.

Keyword

Supradiaphragmatic liver; MRI; Hepatocyte-specific contrast agent; Gadoxetic acid (Gd-EOB-DTPA, Primovist); Intrathoracic mass

MeSH Terms

Diagnosis
Hepatocytes
Liver*
Lung
Magnetic Resonance Imaging

Figure

• 

  Fig. 1 Supraddiaphgramatic liver in a 57-year-old woman. a-d. Dynamic liver CT images after contrast injection demonstrate a well-defined nodular mass (arrowheads) near the diaphragm. The mass shows similar dynamic enhancement to that of liver in arterial phase (a), portovenous phase (b) and delayed phase (c). Bridging vessel (arrow) from liver is visualized on coronal reformatted image of arterial phase (d).

• 

  Fig. 2 Supraddiaphgramatic liver in 57-year-old woman. a. Fat saturated T2-weighted (SPIR, slice thickeness = 3 mm, TR/TE = 1964/70 msec) axial MR images demonstrate the supradiaphragmatic mass (arrowheads) with isosignal intensity comparable to liver parenchyma. b. In contrastenhanced 3D T1 weight images (Gd-EOB-DTPA, flip angle = 10°, TR/TE = 3/1.5 msec), the supradiaphragmatic mass (arrowheads) showed similar dynamic enhancement (portal phase, which is 2 minutes after contrast injection, is shown). c, d. In the hepatobiliary phase (20 minutes after contrast injection), the supradiaphragmatic mass (arrowheads) exhibits the same amount of contrast uptakes comparable to liver parenchyma. SPIR = spectral presaturation inversion recovery

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