Resovist-Enhanced MRI for Preoperative Assessment of Colorectal Hepatic Metastases

Extensive preoperative assessment of hepatic metastases is required in colon cancer patients. We report a case in whom the preoperative investigation by ultrasound scan and contrast-enhanced computed tomography revealed numerous cystic lesions of the liver, suspicious of von Meyenburg complex. Magnetic resonance and magnetic resonance cholangiographic images demonstrated typical features of von Meyenburg complex. Further Resovist-enhanced magnetic resonance imaging detected two hemangiomas in addition to the multiple cystic lesions. So-called Kupffer cell imaging strongly helped the detection of these hemangiomas, and a combination of various magnetic resonance pulse sequences was of great value for the differential diagnosis of cystic lesions and hemangiomas. In cases in whom conventional imaging studies fail to give a definite diagnosis, such as in the present case, superparamagnetic iron oxide-enhanced magnetic resonance imaging is meaningful for adequate preoperative staging.