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;. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]