Hepatic cyst

Hepatic cysts are common liver lesions that are seen in up to 5% of the population. Most cysts are congenital malformations derived from bile duct epithelia and should disappear during the development of the biliary tract. Liver cysts are composed of a thin capsula and are filled with fluid, they are either single or multiple.

MRI appearance of a hepatic cyst without (pre-contrast) and with Primovist^®

With the MRI hepatic cysts appear hypointense (dark areas) on T1-weighted images (left-hand-side) and homogenously hyperintense (bright areas) on T2-weighted images (right-hand-side).

In the liver-specific phase, hepatic cysts show no change in signal intensity compared to the pre-contrast T1-weighted images.

Hepatic cysts

Precontrast: T1-weighted sequence: hypointense (arrow) lesion

Precontrast: T2-weighted: hyperintense liver cyst (arrow)

Therapy

Non-parasitic liver cysts become symptomatic when they are large enough to cause pain, nausea, vomiting, early satiety, and obstructive jaundice. Treatment modalities include percutaneous drainage, open de-roofing, hepatic resection and more recently, laparoscopic de-roofing. Open surgery cyst de-roofing gives marked symptomatic relief with a very low complication rate. In today’s era of laparoscopic surgery, it has a definite role in the management of symptomatic liver cysts, more so in recurrent cysts following laparoscopic treatment.