UTILITY OF T2 WEIGHTED AND DIFFUSION WEIGHTED SEQUENCES IN MAGNETIC RESONANCE IMAGING IN DIFFERENTIATION OF BENIGN AND MALIGNANT LIVER LESIONS: BENEFITS OF SINGLE VERSUS COMBINED SEQUENCES- ONE YEAR HOSPITAL BASED OBSERVATIONAL STUDY

Abstract

Background: The increased use of imaging technology has contributed to an increase in the overall number of focal liver lesions (FLL) that are found incidentally. The vast majority of FLLs that arise in livers that are not cirrhotic are benign and do not progress to malignancy. The most common forms of solid benign tumours are adenomas, focal nodular hyperplasias, and hemangiomas. After metastases, the most frequent malignant lesions that occur in non-cirrhotic liver are hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Accurate characterization of liver masses allows for the avoidance of potentially disastrous outcomes, such as delayed treatment of malignant tumours or treatment that is not essential for benign lesions. In order to reduce the number of needless liver biopsies that are performed, it is of the highest significance to improve the sensitivity and accuracy of cross-sectional imaging for these incidental hepatic lesions. Though detection and characterization of FLLs mainly depends on dynamic enhanced magnetic resonance imaging (MRI), for patients with contraindications such as an allergy to contrast agents, unenhanced MRI sequences, such as T2-WI and DWI have proven crucial in the identification and diagnosis of FLLs. Based on signal intensity of the lesion, T2WI can differentiate benign cystic lesions from malignant solid lesions. Though DWI is beneficial for lesion detection and characterization, it has not yet replaced T2WI in routine use because it has many advantages and limitations simultaneously. This study mainly focuses on the combined ability of both the sequences to improve the diagnostic ability.