 This case is a 44 year old gentleman history is follow-up of liver masses So here we have the liver MRI for this patient. We'll start off looking at our t2-weighted sequences As we scroll through the t2-weighted sequences, this is a single-shot Spineco sequence We can see that there are numerous liver lesions scattered throughout the liver Variable size some larger than others some have lobulated borders We can see that they're fairly hyper intense on this sequence and I'm just gonna sort of look at one representative lesion in order to describe it a little bit more So if we see this large lesion over here, we can see that the internal content is very t2 hyper intense But again, we're not going to use this sequence to really judge the t2 signal of any lesion We're going to use the turbo-spineco sequence over here on this one indeed look how bright this content is of this of this mass If we see this content this bright looks so similar to CSF. We're going to be Not too worried about this lesion probably going to be assist maybe a hemangioma We're going to look at some of the other imaging sequences to sort that out Next we're going to look at the t1 in and out of phase sequence We're looking for areas of signal loss on the out of phase sequence over here Areas of signal loss on the in phase sequence over here, and if we sort of take a Global survey of all these liver lesions. We can see that they look pretty similar in all the imaging sequences And if we look at that representative lesion in the right a patec low We can see that it has t1 hypo intense signal and That doesn't change between the out of phase sequence over here and the in phase sequence over here Next up we're going to look at the pre and post contrast sequences again These lesions all on the pre-contrast sequence look like they're hypo intense t1 hypo intense We're going to look at that large lesion again. This is the arterial phase image over here We see that there's no contrast enhancement Next up we're going to look at the t1 pre-contrast sequence. We can see all these lesions again have that t1 hypo intense signal with respect to the liver prankima This large representative lesion again very homogeneous in its signal and t1 hypo intense with respect to the remaining liver prankima as are the other liver lesions That are present in for this patient and finally we're going to look at the dynamic post contrast imaging sequences to assess if There's any internal enhancement within these lesions And again, we'll look at the representative lesion in the right a patec lobe You can see the lesion here on the Arterial phase images we see the lesion here on the portal venus phase images and finally here on the equilibrium phase images And it looks jet black on all these sequences No enhancement scene and We can also see that around the rim of it Maybe there's a minimal minimal imperceptible rim enhancement and that's okay, but internally inside of it There's absolutely no enhancement identified so These findings are compatible with multiple cysts and given the multiplicity of the lesions you got to think about autosomal dominant polycystic liver disease Now this is a Finding that can be seen It's not that common it can be seen with other cysts and organs such as the kidneys or it can be isolated as well and Often patients start off being asymptomatic So no real symptoms, but as the cysts increase in size you can start to get pain Like any other cysts they can rupture and cause hemorrhage Potentially get infected as well if symptomatic patients will need to undergo resection or again marsupialization So this is basically Multiple liver cysts seen in patients and typically we're talking about more than 10 or 20 liver cysts You got to start thinking about this this entity