Patients can live for many years with NAFLD, but many about 30% eventually end up with an inflamed liver or NASH (non-alcoholic steatohepatitis), and scarring. Unenhanced CT demonstrates hepatic iron deposition through an increase in HU value (>75HU) (Fig. Benign Solid Lesions The Contribution of Science to Diagnostic Imaging, Field Strength in MR, Clinical Perspectives. Inherited genetic haemochromatosis causes hepatocyte iron accumulation (leading to subsequent cirrhosis) and iron accumulation in other organs, including myocardium, skin and endocrine glands. Mahmood S, Inada N, Izumi A, Kawanaka M, Kobashi H, Yamada G. Wilson's Disease Masquerading as Nonalcoholic Steatohepatitis. may email you for journal alerts and information, but is committed
The X and Y descents are also normally demonstrated. The authors declare no conflicts of interest. Pat yourself on the back and keep doing what you are. MD, PhD; De Vos-Geelen, Judith MD; Mihl, Casper MD, PhD,, From the Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, CARIM School for Cardiovascular Diseases, Maastricht University, Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center. 3. The most common cause of hyperechogenic liver (increased liver echogenicity compared with the renal cortex) in routine practice is steatosis, otherwise known as fatty liver. Review/update the
16. 31-14). New York, N.Y.: McGraw-Hill; 2013. http://accessmedicine.mhmedical.com. Diffuse hepatic steatosis,also known as fatty liver, is a common imaging finding and can lead to difficulties assessing the liver appearances, especially when associated with focal fatty sparing. (B) Caudal section demonstrating the gallbladder displaced into the midline. 19th ed. flow volumes correspondingly. As the liver atrophies in end-stage cirrhosis, the hepatic veins may become attenuated and difficult to visualise. Malignant Solid Lesions Scintigraphy Reference article, Radiopaedia.org (Accessed on 02 Mar 2023) https://doi.org/10.53347/rID-6853, Case 5: with concurrent iso-dense gallstones, non-alcoholic fatty liver disease (NAFLD), World Health Organization 2001 classification of hepatic hydatid cysts, recurrent pyogenic (Oriental) cholangitis, combined hepatocellular and cholangiocarcinoma, inflammatory myofibroblastic tumor (inflammatory pseudotumor), portal vein thrombosis (acute and chronic), cavernous transformation of the portal vein, congenital extrahepatic portosystemic shunt classification, congenital intrahepatic portosystemic shunt classification, transjugular intrahepatic portosystemic shunt (TIPS), transient hepatic attenuation differences (THAD), transient hepatic intensity differences (THID), total anomalous pulmonary venous return (TAPVR), hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease), cystic pancreatic mass differential diagnosis, pancreatic perivascular epithelioid cell tumor (PEComa), pancreatic mature cystic teratoma (dermoid), revised Atlanta classification of acute pancreatitis, acute peripancreatic fluid collection (APFC), hypertriglyceridemia-induced pancreatitis, pancreatitis associated with cystic fibrosis, low phospholipid-associated cholelithiasis syndrome, diffuse gallbladder wall thickening (differential), focal gallbladder wall thickening (differential), ceftriaxone-associated gallbladder pseudolithiasis, biliary intraepithelial neoplasia (BilIN), intraductal papillary neoplasm of the bile duct (IPNB), intraductal tubulopapillary neoplasm (ITPN) of the bile duct, multiple biliary hamartomas (von Meyenburg complexes). Severe scarring has built up, making it difficult for the liver to function properly. In (B) the presence of septae, central low attenuation along with a sympathetic pleural effusion aid the diagnosis. This can be either diffuse or focal. Correspondence to: Bibi Martens, MD, Maastricht University Medical Centre, P. Debyelaan 25, PO Box 5800, 6202 AZ Maastricht, the Netherlands. 31-32). Radionuclide imaging of the liver for lesion characterisation has been largely superseded by the other techniques but is employed when they are unavailable or inappropriate. MR-based quantification has been developed for the measurement of hepatic steatosis, iron and fibrosis using chemical shift imaging, T2 and T2* relaxometry and elastography. You may search for similar articles that contain these same keywords or you may
Investigative Radiology55(10):666-672, October 2020. Angiography may be used to assess vascular complications such as variceal bleeding and portal hypertensive changes. This phenomenon is called acoustic attenuation and is . If there are other problem at
High-quality T2w imaging can be obtained with respiratory-triggered multi-shot RARE sequences and pre- and multiphase post-gadolinium imaging using rapid breath-hold 3D T1w volume imaging is now routine. Radiology. The most significant complication of liver fibrosis can be liver cirrhosis, or severe scarring that makes the liver so damaged a person will become sick. It is kind of CT arteriography (CTA) and CT arterioportography (CTAP) using direct hepatic artery injection during CT examination and Lipiodol CT are now rarely used. The hepatic veins are seen routinely on digital subtraction angiography but the portal vein is not normally visualised on an arteriogram unless there has been flow reversal or an arterioportal shunt is present. 7. (A) Normal liver, (B) haemochromatosis, (C) transfusion-related haemosiderosis and (D) variant haemochromatosis. drugs: amiodarone, methotrexate, chemotherapy (e.g. Dual energy CT images of a hepatocellular carcinoma. Several studies have demonstrated that hepatic iron concentration correlates strongly with both T2* and T2 value, permitting accurate quantification. For these, please consult a doctor (virtually or in person). Know what's in the medications you take. Watch your saturated fat and sugar intake to help keep your cholesterol and triglyceride levels under control. alcohol, pregnancy, obesity, diet. Drug record: Herbal and dietary supplements. The presence of steatosis leads to marked signal reduction on (B) owing to cancellation of the water and fat signal when present in the same voxel. Contrast-enhanced CT scan shows low-attenuation masslike nodular material causing scalloping of liver contour (arrowheads). This results in: Sonoelastography(e.g. The hepatic veins are seen routinely on digital subtraction angiography but the portal vein is not normally visualised on an arteriogram unless there has been flow reversal or an arterioportal shunt is present. On non-contrast CT, moderate to severe steatosis (at least 30% fat fraction) is predicted by: A subjective grading system has been proposed to describe the degree of hepatic steatosis based on hepatic density and visualization of hepatic vessels (hepatic veins and portal vein). information submitted for this request. metastases (Fig. In contrast, homogeneous hyperenhancement with rapid washout and delayed hypoattenuation relative to the liver raises concern for malignancy. A Case of Liver Metastasis from Colon Cancer Masquerading as Focal Sparing in a Fatty Liver. Sulphur colloid is cleared rapidly from the bloodstream (t1/2 = 2min) and in patients with normal liver function imaging may begin 510min after injection but in those with compromised hepatic function and/or portal hypertension, optimal concentration of the sulphur colloid will take longer and imaging can be delayed to take account of this. Herbs and supplements to avoid include black cohosh, ma huang and other Chinese herbs, comfrey, germander, greater celandine, kava, pennyroyal, skullcap, and valerian. A homogeneous liver is one that has the same texture Liver transplantation is also an option for some patients. Material and . Once youve been diagnosed with cirrhosis, it cant be reversed, but there are treatment options that can slow it down, or stop it. Of these, about 20% will develop end-stage cirrhosis, which can lead to liver failure and cancer. Fibrosis. https://livertox.nih.gov/Herbals_and_Dietary_Supplements.htm. Radiographics. Normal liver volume, derived from postmortem studies of liver weight, ranges from 1 to 2.5kg, and varies with gender, age and body mass. Kato M, Saji S, Kanematsu M et al. Delayed CT imaging is used in selected cases, e.g. With increasing fat infiltration the liver attenuation decreases, reversing, in turn, the normal liverspleen difference and liverblood difference (Fig. An enlarged liver might not cause symptoms. Overall subjective image quality was assessed by 2 experienced readers by using a 5-point Likert scale. Abdom Imaging. For example, a dermoid cyst has heterogeneous attenuation on CT. On US capillary haemangiomas are typically well-defined, lobular, homogeneous lesions with increased echo reflectivity (Fig. What are the advantages and disadvantages of video capture hardware? Medical Definition of homogeneous : of uniform structure or composition throughout. Shetty A, Sipe A, Zulfiqar M et al. The enhancement characteristics for many focal lesions are, not surprisingly, similar to those for CT. Hepatobiliary specific agents have been developed which target either the reticulo-endothelial system (RES) or hepatocytes. J.E. 19. The liver is a large, football-shaped organ found in the upper right portion of your abdomen. (Reproduced with permission from Blumgart, in Surgery of the Liver and Biliary Tract, Churchill Livingstone, 1994.). vascular thrombosis with HCC) may be helpful, but in the appropriate clinical context biopsy may be required to detect diffuse malignant involvement. In most cases, a finding of heterogeneous liver is followed by further medical testing to determine the cause of the heterogeneity. Malignant Lesions 2010;20(2):359-66. Normal liver echogenicity is homogeneous, with fine echoes. 22. When enlarged liver results from liver disease, it might be accompanied by: Make an appointment with your doctor if you have symptoms that worry you. The liver texture becomes coarser or more heterogeneous as cirrhosis progresses, but this is difficult to quantify and subjective. The evaluation of a sulphur colloid scintigram involves an assessment of liver size, shape, distribution of the radiopharmaceutical within the spleen, liver and bone marrow, and the homogeneity of uptake within the liver and spleen. The liver signal is abnormally reduced (to less than that of adjacent muscle). The main feature of the inferior or visceral surface is the porta hepatis or hilum, a central depression conveying the portal vein, hepatic artery and common bile duct. Radiographics. Fatty liver disease is a common cause of an echogenic liver. In this circumstance the hepatic veins drain direct to one of the cardiac atria with the azygos vein replacing the IVC, passing posterior to the diaphragmatic crura into the chest. Scintigraphy will demonstrate large cysts as non-specific photopenic regions. As cirrhosis progresses, widespread fibrosis and nodular regeneration develop, along with macroscopic changes of liver morphology which can be detected on imaging. Skin and eyes that appear yellowish (jaundice). In physics, attenuation (in some contexts, extinction) is the gradual loss of flux intensity through a medium.For instance, dark glasses attenuate sunlight, lead attenuates X-rays, and water and air attenuate both light and sound at variable attenuation rates.. When a report only states homogeneous attenuation, it only shows that the spleen and liver appear normal and that there are no unusual masses . Your doctor may treat your symptoms caused by cirrhosis by recommending lifestyle changes, medication, or transjugular intrahepatic portosystemic shunt (TIPS). (A) Arterial phase at 140 kV, (B) arterial phase at 70 kV, (C) reconstructed virtual unenhanced image (comparable with an acquired unenhanced image) and (D) reconstructed iodine image. Call your doctor or 911 if you think you may have a medical emergency. CT defines all these features as well (Fig. I am currently continuing at SunAgri as an R&D engineer. The groups differed in age and the level of liver attenuation on both CT scans. In primary sclerosing cholangitis caudate lobe hypertrophy is found in virtually all cases and the lateral segments of the left lobe (II, III) occasionally atrophy. Studies using DWI and 31P spectroscopy have given mixed results for trying to grade fibrosis. Chemical shift artifact at the parenchyma-vessel interface aids in detecting this situation 13. Therefore, the aim of our review was to evaluate the recently published studies on the treatment of NAFLD patients. This is abnormal and results from a gas-forming organism in an abscess or infarct, or occasionally following trauma or hepatic arterial thrombosis following liver transplantation. Steatosis manifests as increased echogenicity and beam attenuation 2,12. Some metastatic lesions have a predominantly cystic appearance. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Abele J & Fung C. Effect of Hepatic Steatosis on Liver FDG Uptake Measured in Mean Standard Uptake Values. And even when it does, it's most often simply a finding of note, but not of consequence. Another method to quantify the grade of steatosis can be made by taking the relative IP and OOP values of the liver and the spleen, using the following formula (percentage of signal intensity loss)21: [(Liver IP / Spleen IP)- (Liver OOP / Spleen OOP) ] / [(Liver IP / Spleen IP)] x 100. MR Elastography of the Liver at 3 T with Cine-Tagging and Bending Energy Analysis: Preliminary Results. The main risk of NAFLD is cirrhosis, which can limit your livers ability to do its job. This holds for all sequence combinations except for inversion recovery techniques with inversion times that completely null liver signal. What is A person who sells flower is called? Early changes may be detectable only on histological examination. 1 One of the main causes of heterogeneous echogenicity of the liver is chronic liver disease/cirrhosis (Figure 1 of the supplementary material). Modern techniques allow all four image sets to be generated from a single breath-hold 3D T1w acquisition. Check with your doctor if you're not sure what's too much. In situations in which there is >50% fatty infiltration, the out-of-phase sequence paradoxically becomes lesshypointense than at 50%. CONFLICT OF INTEREST STATEMENT. 31-10). Mayo Clinic does not endorse companies or products. MR-based quantification has been developed for the measurement of hepatic steatosis, iron and fibrosis using chemical shift imaging, T2 and T2* relaxometry and elastography. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. privacy practices. Epilepsy is a brain disease in which a cluster of neurons sometimes induces episodes of abnormal excitation, called epileptic seizures. US sensitively detects moving gas bubbles in the main portal vein which can be visualised on B-mode images and detected by spectral Doppler as the gas bubbles reflect the sound beam overloading the system receivers giving rise to a characteristic high-pitched random bubbling sound with focal aliasing artefacts on the spectral display. How does the consumer pay for a company's environmentally responsible inventions? Posteriorly the caudate lobe separates the porta from the inferior vena cava (IVC). Portal phase CT images (A) in a patient with portal vein gas (note the peripheral distribution (arrows)) and (B) in a patient with pneumobilia (arrowheads). enhancement with IV Gd-DTPA on T1w images. Look for "acetaminophen," "acetam" or "APAP." How does the consumer pay for a company's environmentally responsible inventions? Portal phase examinations in two different cases. A typical abscess, with reduced echo reflectivity and a thickened irregular wall (arrowheads). Patients and methods: A series of 165 patients with no signs or symptoms of liver disease referred because of slightly to moderately raised aminotransferases (alanine aminotransferase and/or aspartate aminotransferase 0.7-5.0 . Lifestyle modification, including weight loss, physical activity, and dietary changes, is the first-line therapy. On US examination non-specific decreased reflectivity occurs in acute viral hepatitis, although the majority of cases have normal parenchyma. Conflicts of interest and sources of funding: This manuscript has not received any funding. Several intrinsic liver pathologies can cause a diffuse change in liver attenuation with increased hepatic fat being the most prevalent. US will demonstrate gas collections but defining their extent may be difficult when they are large or peripheral and may be confused with adjacent bowel. AJR Am J Roentgenol. Then figure out what the total cost of the trip would be.? Massive hepatic necrosis occurred more frequently among the heterogeneous low-attenuation group than among the homogeneous low-attenuation group. Normal hepatic vein on duplex Doppler US. Note the hepatic veins are unenhanced (black arrows) on the arterial phase but opacify on the portal phase. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. AJR Am J Roentgenol. Then figure out what the total cost of the trip would be.? Can Helicobacter pylori be caused by stress? Axial sections at the same location following a bolus of IV contrast medium demonstrating clearly the hepatic vessels and phases of enhancement: (A) unenhanced, (B) arterial phase and (C) portal phase. True hepatic cysts arise from abnormal development of bile duct precursors (Meyenburgs complexes) and are lined by cuboidal epithelium. (A) Single-shot RARE (SSFSE/HASTE) TEeffective 60ms, which is most useful for detecting long T2 value lesions (cysts/haemangiomas) and (B) fat-suppressed multi-shot RARE (FSE/TSE) TEeffective 60ms, which is more sensitive to intermediate T2 value lesions such as metastases, benign tumours and HCC. Ultrasound Where is H. pylori most commonly found in the world? Radiology Review Manual. Fabbrini E, Conte C, Magkos F. Methods for Assessing Intrahepatic Fat Content and Steatosis. The authors report no conflicts of interest. The liver signal is abnormally reduced (to less than that of adjacent muscle). 1992;33(2):258-9. 2009;12(5):474-81. Unenhanced CT section, showing a large metastasis in the left lobe of the liver from a colonic adenocarcinoma. Gallbladder wall thickening is a common non-specific finding in acute hepatitis. US clearly demonstrates focal calcification, with increased reflectivity and a posterior acoustic corridor, but this feature alone does not always allow distinction from focal gas. In the early stages abscesses may mimic solid tumours such as metastases on virtually all imaging techniques and aspiration or biopsy may be necessary for diagnosis. Study objective. (A) Multiple low attenuation lesions with ring enhancement (arrowheads); these appearances are often non-specific on CT and often overlap with those of metastatic deposits. Exercise, paired with diet, can help you lose weight and manage your liver disease. Fill your fruit basket with apples, grapes and citrus fruits like oranges and lemons, which are proven to be liver-friendly fruits. multiphase post-gadolinium imaging using rapid breath-hold 3D T1w volume imaging is now routine. What is the meaning of liver is normal in size with homogenous parenchyma. 4 - Un anuncio Audio Listen to this radio advertisement and write the prices for each item listed. Some primary hepatic tumours, including hepatocellular carcinoma, may present with non-specific diffuse infiltrative changes. It occurs in up to 5% of adults and consists of abnormal blood vessels. 11. https://www.liverfoundation.org/for-patients/about-the-liver/health-wellness#1507301343822-50491142-06d3. This effect is most sensitively detected by T2*w gradient-echo imaging although with significant accumulation the effect is easily seen on T2w spin-echo images, and when severe will affect T1w images. Fatty liver disease is characterized by the accumulation of fat within liver . modify the keyword list to augment your search. The calcification is well demarcated and surrounded by otherwise normal parenchyma. Several of these methods provide absolute quantification of liver stiffness and large trials suggest that these techniques may have a role in the detection and quantification of liver fibrosis although their exact role in patient management is not yet clear. Internal echoes, thick septations, a perceptible wall or solid components should prompt further imaging (by CT or MRI) or aspiration as the differential diagnosis includes haemorrhage, abscess, cystic metastasis (e.g. These techniques are undergoing standardisation and validation but are starting to enter routine clinical practice. The hepatic veins make a triangular impression on the superior, central margin of the liver, and the porta hepatis makes an impression on the inferomedial segment of the right lobe. lung involvement. Most patients who develop chronic liver failure have underlying cirrhosis. Factors that can increase your risk of liver problems include: Large doses of medicines, vitamins or supplements. Focal nodular hyperplasia, which often develops in women and has a scar-like appearance. Plain radiographs demonstrate gross calcification, but unenhanced CT is more sensitive and detects subtle calcification, e.g. to maintaining your privacy and will not share your personal information without
During the arterial phase following IV enhancement with Gd-DTPA haemangiomas have rapidly enhancing vessels at the periphery. This site complies with the HONcode standard for trustworthy health information: verify here. phase imaging, may be obtained. Mn-DPDP (mangafodipir trisodium), Gd-BOPTA (gadobenate dimeglumine) and most recently Gd-EOB-DTPA (gadoxetate) are all hepatocyte-specific paramagnetic agents which accumulate in hepatocytes followed by biliary excretion. Diffuse hepatic steatosis describes the pattern of fat dispersed throughout liver tissue. Martens, Bibi MD,; Wildberger, Joachim E. MD, PhD,; Hendriks, Babs M.F. You may opt-out of email communications at any time by clicking on
liver amyloidosis), acute hepatitis, or acute liver failure [6], [7]. The MRI findings also overlap with necrotic metastases with an ill-defined lesion on low signal on T1w and high signal on T2w, often with a higher signal outer margin. American Liver Foundation. That means you have fatty liver. In severe cases, epileptic discharges can spread to a broad . (a) B-mode image. Anatomy the unsubscribe link in the e-mail. Hepatic pyogenic abscesses usually arise from portal pyaemia. Angiography What is the mechanism action of H. pylori? Checking a tissue sample. 2006;26(6):1637-53. CT (Fig. However, it may be associated with 1: Radiolucent liver sign: liver soft-tissue outline becomes difficult to appreciate 5. 12. Hepatosplenomegaly is enlargement of the liver and spleen. High fiber diet, exercise, weight loss, alcohol avoidance will help with the recovery. 31-24) best delineates parenchymal gas collections and any related pathological changes. 1998;23(4):409-15. The spleen is normally higher signal than the liver. Typical appearance on T2w sections: (A) TEeffective 60ms single-shot RARE, (B) TEeffective 160ms single-shot RARE and (C) TEeffective 60ms multi-shot fat-suppressed RARE. your express consent. As the lesions liquefy, the central signal decreases on T1w and increases on T2w imaging. Accessed Feb. 5, 2018. Portal phase imaging can be helpful in assessing portal vein patency, although flow volume and direction cannot be determined. This content does not have an Arabic version. Peripheral indentations on the liver are normally produced by the lateral rib margins, xiphoid process, gallbladder, right kidney and heart. detectable due to more rapid flow rates. 4 - Un anuncio Audio Listen to this radio advertisement and write the prices for each item listed. Aim to get at least 30 minutes of aerobic exercise on most days of the week. (A) Cranial section on which the principal plane is marked by the arrow and the falciform ligament by an arrowhead. 4. After giving off the gastroduodenal artery, the main hepatic artery continues and divides into the right and left hepatic arteries. The true incidence is unknown and they are indistinguishable from cysts that arise as the long-term sequelae of parenchymal haematomas or abscesses. (b) Transient elastography (TE) and controlled attenuation parameter (CAP) with FibroScan.Sample display showing the echo M-scan on the left . CT (Fig. In chronic hepatitis CT, MRI and angiography are of limited value until cirrhotic changes develop. These conditions are fulfilled in neonatal necrotising enterocolitis but also in adults with gastric emphysema, intestinal obstructions, infections and Crohns disease. The pressure difference between measurements in the wedged (occluded) hepatic vein and the IVC (the corrected sinusoidal pressure) is normally between 4 and 8mmHg. J. Liver parenchyma is homogeneous with attenuation values of 5460 Hounsfield units (HU), usually 810 HU greater than the spleen. 31-22 and 31-23) demonstrate clearly pneumobilia and its distribution. If this is not homogenous, then I might indicate some issues. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Absence of the IVC is rare and associated with complete situs inversus but may occur with partial situs and a right-sided liver. If sufficient gas accumulates it may become visible on CT peripherally in the portal vein branches and eventually becomes evident on plain radiographs. The peripheral intrahepatic biliary tree is not normally visualised, although the main right and left hepatic ducts and the common hepatic and bile ducts are normally demonstrated. A Solution for Homogeneous Liver Enhancement in Computed Tomography: Results From the COMpLEx Trial : Investigative Radiology . If it does cause problems, your symptoms will depend on the type you . what is a t2 hyperintense liver lesion. Variations of the hepatic arterial supply are important for radiologists and hepatic surgeons. American Liver Foundation. The significance and outcome largely relates to the underlying aetiology. On MRI marked heterogeneity may occur in cirrhotic livers on (A) multi-shot T2w FSE imaging due to the combination of increased signal from fibrosis and reduced signal from iron accumulation within nodules and for similar reasons on delayed post-gadolinium T1w imaging (B). New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. Haemangiomas are the commonest benign hepatic tumours with a postmortem prevalence of 420% and may be multiple in 10% of these. Kim D, Park S, Lee S et al. Mean attenuation values in groups 1, 3, and 4 were comparable (118.2 10.0, 117.6 13.9, 117.3 21.6 HU, respectively), whereas attenuation in group 2 (141.0 18.2 HU) was significantly higher than all other groups (P < 0.01). Direct methods (including percutaneous splenic, transhepatic and transjugular approaches) are now used only when therapeutic procedures (e.g. Tom W, Yeh B, Cheng J, Qayyum A, Joe B, Coakley F. Hepatic Pseudotumor Due to Nodular Fatty Sparing: The Diagnostic Role of Opposed-Phase MRI. Doppler US examination may reveal other non-specific features of cirrhosis: damping of the normal right heart waveforms in the hepatic veins, reduced main portal vein blood flow (<10cm/s mean peak) or hepatofugal flow. Hepatic arterial flow is usually increased in advanced cirrhosis as the portal contribution to hepatocyte perfusion decreases. There are no licensed drug treatments, although use of pioglitazone or vitamin E may be . The shape and vascular architecture of the liver are normal. Besides being the ingredient in OTC pain relievers such as Tylenol, it's in more than 600 medications, both OTC and prescription. To assess the prognostic value of liver attenuation on CT scan in patients with COVID-19. MRI also defines the cystic structure and internal anatomy but is insensitive to the calcification. Iron oxide particles possess superparamagnetic properties that create susceptibility-induced dephasing of protons, thereby shortening T2. Benign Cystic Lesions Not a serious condition. Scintigraphy and MRI are insensitive to calcification. The availability of the iron agents varies across the world and in some regions they have been withdrawn probably due to declining utilisation. what is physiologic activity in liver and spleen. This can occur due to a number of reasons which include: conditions that cause hepatic fibrosis 1. cirrhosis.