Benign focal liver lesions: The role of magnetic resonance imaging

Figure 15  A 38-year-old female, smoker, polycystic ovary syndrome, previous appendicectomy. Abdominal ultrasound performed due to neutropenia demonstrated hyperechoic liver nodules. Subsequent liver magnetic resonance imaging confirmed multiple liver nodules hypointense in T1-weighted sequences slightly hyperintense on T2 sequences, with increased signal on diffusion weighted images, without contrast enhancement after dynamic study with gadoxetic. Lesions are hypointense on the hepatobiliary phase. Chest computed tomography with contrast demonstrated bilateral nodules with a perilymphatic pattern and a bigger lesion with satellite nodules (galaxy sign) on the right; increased hilar lymph nodes were present. Transbronchial biopsy demonstrated noncaseating granulomas which led to the diagnosis of sarcoidosis. A: Liver ultrasound image; B: Out-of-phase T1-weighted image; C: In-phase T1-weighted image; D: T2-turbo spin echo; E: Portal venous phase magnetic resonance imaging (MRI); F: Chest computed tomography (CT) with pulmonary parenchymal window; G: Ultrasound image; H: T2-Spectral Attenuated Inversion Recovery; I: High b-value diffusion weighted imaging; J: Arterial phase MRI; K: Hepatobiliary phase MRI; L: Chest CT with mediastinal window.