Sith Phongkitkarun MD*, Tichakorn Srianujata MD*, Janjira Jatchavala MD*
Affiliation : * Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the supplemental MRI value in characterization of small hepatic lesions (< 20 mm)
indetermined by routine CT scan.
Material and Method: This was a retrospective study. Sixty-four patients with 81 indeterminate small hepatic
lesions on the CT scan were included in this study. Two radiologists simultaneously evaluated the CT scan,
followed  by  MRI.  Patient  history,  imaging  record,  and  final  diagnosis  were  blinded.  Final  diagnoses  were
made by interpretation of all medical data and defined these lesions as benign or malignancy by using either
histology or follow-up imaging combined with laboratory data.
Results :  In  64  patients,  62  lesions  (76.5%)  of  81  indeterminate  lesions  were  benign,  whereas  19  lesions
(23.5%) were malignant. MRI interpreted 55 lesions as benign, 17 lesions as malignant, and 9 as indeterminate
lesions. If the indeterminate lesions were assumed as benign lesions, sensitivity, specificity, positive predictive
value (PPV), and negative predictive value (NPV), are 68.4%, 93.6%, 76.5%, and 90.6%, respectively.
Conclusion : MRI can supplement CT scan in characterization of small hepatic lesion with high specificity and
accuracy.
Keywords : Liver diseases, Liver neoplasms, Magnetic resonance imaging, Tomography, X-ray computed
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