Gromov A.I.¹, Baev A.A.2, Edigarova D.M.3


1 - A.I. Evdokimov Moscow State University of Medicine and Dentistry

2 - Russian Medical Academy of Continuing Professional Education

3 - Clinical hospital №2 of “MEDSI group”. Moscow, Russia.



Purpose. To demonstrate the capabilities of MRI in the diagnosis of a rare benign liver tumor – leiomy-oma based on its specific signal characteristics.

Material and methods. The article analyzes the publicly available literature on the characteristics and possibilities of diagnosing a rare variant of a benign liver tumor – leiomyoma. All possible for-mations in the liver that have a reduced MR signal on T2-weighted images are systematized. A clinical observation of patient B., 48 years old, is presented. An abdominal ultrasound revealed a hypoechoic subcapsular mass. On CT scan of the abdominal organs, the formation has a slightly reduced density. An MRI of the liver was performed with contrast.

Results. On MRI, the formation had clear, even contours, a hypointense MR signal on T2-WI and T1-FS, did not limit diffusion, and moderately progressively accumulated a contrast agent with a maximum in the delayed phase during dynamic contrast enhancement. Taking into account the hy-pointensity of the detected formation both on T2-WI and T1-FS, which is similar to the signal of striat-ed muscles, as well as the dynamics of the accumulation of the contrast agent, a judgment was made about the presence of liver leiomyoma. A needle biopsy of the identified lesion was performed. Morpho-logical and immunohistochemical studies indicated leiomyoma.

Discussion. The hypointensity of formation on both T2-WI and T1-WI, which is extremely rare in all other, more common, liver tumors, as well as the similarity of the MR signal of formation to the MR signal of the muscles, made it possible to speak confidently in favor of leiomyoma. Other focal pathological structures in the liver, which can also have a low signal intensity on both T2-WI and T1-WI – hematomas, calcifications, are avascular formations and should not change the MR signal with contrast enhancement. The presence of a feeding vessel, detected by ultrasound in the Doppler scan-ning mode, also speaks in favor of the tumor nature of the formation.

Conclusions. Magnetic resonance imaging makes it possible to establish the presence of liver leiomyoma based on the low intensity of the MR signal on both T2-WI and T1-WI, similarly to muscles, and confirmation of the fact of accumulation of a contrast agent with dynamic contrast enhancement.


Keywords: Benign liver tumors. Leiomyoma of the liver. MRI diagnosis. Decreased MRI signal in-tensity on T2-weighted images.



Corresponding author: Gromov A.I., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Gromov A.I., Baev A.A., Edigarova D.M. Leiomyoma of the liver. Literature review and observation of primary preoperative diagnosis. REJR 2023; 13(1):70-77. DOI: 10.21569/2222-7415-2023-13-1-70-77.


Received: 19.10.22

Accepted: 22.02.23