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Definition:
Having mildly or moderately higher signal intensity on T2w images than liver.
Usage:
- Mild-moderate T2 hyper-intensity is an ancillary feature favoring malignancy
- Radiologists at their discretion may apply mild-moderate T2 hyperintensity to upgrade category (up to LR-4)
- Do not characterize as mild-moderate T2 hyperintensity
Synonyms:
- Slightly bright T2, Mild-moderate T2 signal
Background:
- Mild-moderate T2 hyperintensity is a feature favoring malignancy based on the following:
- Increased signal on T2 weighted images has been shown to correlate with increased arterial supply and decreased portal venous flow to nodules, which is a finding associated with HCC
- For small T1 hyperintense nodules, benign nodules more often had T2 iso- or hypointensity compared to HCC
- Infiltrative HCC often is T2 hyper-intense, even in the absence of definite arterial hyperenhancement
- Studies have not shown high specificity of mild-moderate T2 hyperintensity for HCC, therefore this is an ancillary feature rather than a major feature for HCC in LI-RADS
References:
Shinmura R. Cirrhotic nodules: association between MRI signal intensity and intranodular blood supply. Radiology 2005
Shimizu A. Small hyperintense hepatic lesions on T1W images in patients with cirrhosis: evaluation with serial MRI and imaging features for clinical benignity. Magnetic resonance imaging 2007
Rosenkrantz A. Infiltrative HCC: comparison of MRI sequences for lesion conspicuity. Clin Rad 2012
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