Diagnosing small hepatic cysts on multidetector CT: An additional merit of thinner coronal reformations

Objective: We wanted to validate the additional merit of the thinner coronal reformation images from multidetector CT (MDCT) for making the diagnosis of hepatic cysts. Materials and Methods: For the 90 benign hepatic cysts confirmed on MRI, the transverse (5-mm thickness) and additional coronal (2-mm thickness) reformation images from MDCT were compared with each other in terms of the Hounsfield units (HUs) and the size of each hepatic cyst. Results: The attenuations (mean: 17.2 HUs, standard deviation: ± 14.4) on the thinner coronal images were significantly lower than those (mean: 40.7 HUs; standard deviation: ± 20.6) on the thicker transverse images for the small hepatic cysts (≤ 10 mm on the transverse image, p < 0.01). Twenty-three (79%) of the 29 cysts between 5 mm and 10 mm and 21 (51%) of 41 lesions up to 5 mm showed a mean HU value of 20 or less on the coronal reformation images. Conclusion: By reducing the partial volume effect, routine coronal reformation of MDCT with a thinner section thickness can provide another merit for making a confidential diagnosis of many small sub-centimeter hepatic cysts, and these small cysts are not easily characterized on the conventional transverse images.