The purpose of this study was to describe the magnetic resonance imaging (MRI) appearance of hepatic alveolar echinococcosis (HAE) on T-1-weighted, T-2-weighted and postgadolinium images. A total of 13 lesions were demonstrated in 13 patients. All patients underwent MR examination at 1 T imager. MR examinations included precontrast T-1-weighted breathing averaged spin echo (SE), breath-hold spoiled gradient echo, T-2-weighted TSE sequences with and without fat suppression, and T-1-weighted breath-hold spoiled gradient echo (SGE) sequence following i.v. after gadolinium administration. All lesions were confirmed with histopathology. HAE hepatic lesions revealed geographic patterns of variable signal intensities on noncontrast T-1- and T-2-weighted images. Slightly hyperintense, iso- and hypointense signal on T-1-weighted images corresponded to calcified regions, which appeared hypo-isointense signal on T-2-weighted images. Necrotic areas were hypointense signal on T-1-weighted and hyperintense signal on T-2-weighted images. On postgadolinium images, lesions did not reveal enhancement. Dilatation of intrahepatic bile ducts distal to HAE abscesses were observed in five patients and portal vein invasion or compression was observed in four patients, lobar atrophy of the liver was coexistent finding in cases with portal vein compression. The MRI appearance of HAE abscesses included large irregularly marginated masses with heterogenous signal on T-1- and T-2-weighted images and lack of enhancement with gadolinium. (C) 2000 Elsevier Science Inc. All rights reserved.