Liver-vessel cancellation artifact on in-phase and out-of-phase MRI imaging: a sign of ultra-high liver fat content

Purpose:

To describe a new MRI sign, the liver‐vessel cancellation artifact, on In‐Phase and Out‐of‐Phase gradient‐echo sequences related to ultra‐high liver fat content (>90%) by qualitative histology.

Materials and Methods:

Institutional review board approval was obtained for this retrospective HIPAA‐compliant study with waived informed consent. Patients with liver steatosis were searched in MRI (n = 195) and pathology (n = 116) databases between January 1, 2008, and June 20, 2010. Two readers blindly reviewed all MR images for the presence of the liver‐vessel cancellation sign. Cross‐reference of patients with biopsy‐proven steatosis and MRI within one month was performed (n = 54; 25 males, 29 females; mean age 41.0 ± 18.9), with a population of 6 patients with ultra‐high liver fat content (1 male, 5 females; mean age 15.5 ± 11.2). Performance diagnostic tests, including sensitivity and specificity, were performed.

Results:

Liver‐vessel cancellation sign was present in all patients with ultra‐high liver fat content but in none of the remaining patients. Calculated sensitivity and specificity for the detection of ultra‐high liver fat content with this sign were 100% (95% confidence interval [CI]: 69.1–100%) and 100% (95% CI: 98.4–100%), respectively.

Conclusion:

The presence of liver‐vessel cancellation artifact around intra‐hepatic vessels is a feature of ultra‐high liver fat content. J. Magn. Reson. Imaging 2012;35:1112‐1118. © 2011 Wiley Periodicals, Inc.