Mucin-producing cysts of the liver. Radiologic-pathologic correlation.

Mucin-producing cysts of the liver - mucinous cystic neoplasm (MCN), intraductal papillary neoplasm of the bile duct (B-IPMN), and ciliated foregut cyst (CFC) - are rare lesions with variable biological behavior and significant malignant potential that pose diagnostic and therapeutic challenges.Gadolinium-enhanced MRI with MR cholangiography sequences is the modality of choice for characterizing these entities, offering unparalleled multiparametric capability that integrates morphological, functional, and anatomical biliary information in a single examination. Beyond diagnosis, accurate imaging interpretation carries direct and consequential management implications: distinguishing MCN or CFC from a simple biliary cyst may preclude unnecessary surgery, while the identification of high-risk features - such as mural nodules, septal thickening, restricted diffusion, or ductal communication - is critical for timely surgical referral and operative planning.Within the multidisciplinary team, the radiologist plays a central and irreplaceable role. A structured and systematic MRI report transforms descriptive findings into clinically actionable information, informing not only the decision to operate, but also the timing, extent, and urgency of surgical intervention. This review aims to highlight how refined imaging characterization of mucin-producing hepatic cysts, integrated with histopathological correlation, enables more precise, individualized, and evidence-based therapeutic decision-making.