Value of diffusion-weighted MRI in evaluation of solid hepatic focal lesions in patients with renal insufficiency

Objectives: To evaluate the diagnostic accuracy of diffusion weighted MRI in diagnosis of solid hepatic focal lesions in patients with impaired renal functions. Patients and methods: This prospective study included (30) patients with impaired renal function and had solid hepatic focal lesions based on ultrasound examination. All patients subjected to diffusion MRI examination and ADC measurement, and the data obtained were compared with histopathological results of malignant lesions and previously reported appearance of benign lesions. Results: There were 57 solid focal lesions in the included 30 patients. The mean ADC value of hemangiomas was 2.03 × 10−3, lipoma was 0.1 × 10−3, HCC was 1.06 × 10−3 and for metastases was 1.2 × 10−3. Benign lesions have significant higher ADC values than malignant ones (p = 0.003), and in malignant lesions the primary hepatic carcinomas had lower ADC values compared to metastatic lesions which had no significant value. Using a cutoff value of 1.6 × 10−3 for the ADC to differentiate between benign and malignant lesions the AUC was 90% with Sensitivity, Specificity, PPV, NPV and accuracy of 92%, 80%, 98%, 50% and 91% respectively. Conclusion: DW-MRI and ADC value measurements are effective in characterizing solid focal hepatic lesions without contrast injection in patients with renal impairment