Background: The multiparametric ability and high-resolution 3T magnetic resonance imaging (MRI) plays a key role in non-invasive characterization of focal liver lesions (FLL). Some FLL have atypical features. New techniques such as diffusion-weighted sequences and hepatocyte-specific contrast agents are being currently used in clinical practice improving the detection and characterization of FLL. The study aimed to validate a high-quality hepatic imaging protocol using high-resolution MRI combined with diffusion and hepatocyte-specific contrast media for FLL diagnosis. Material and methods: 110 patients were liver investigated using a 3T high-resolution MRI (Phillips Ingenia) using body-phase array coil. The protocol included Dixon-all T1, T2, SPAIR and diffusion sequences. The enhanced MRI assumed the use of gadoxetic-acid (PRIMOVIST) Dixon-T1 sequences, including the hepatobiliary phase at 20 minutes and 30 minutes. Results: 65 patients were accurately diagnosed with benign lesions, including hemangiomas, cysts, focal nodular hyperplasia and adenomas. Among 45 malignant lesions we found metastasis, hepatocellular carcinoma (HCC) and one inflammatory pseudotumor. The lesions were followed-up or pathology was obtained. Conclusions: MRI is able to provide comprehensive and highly accurate diagnostic information, with the additional advantage of lack of harmful ionizing radiation. Also a high-quality liver MRI protocol is needed in order to establish a correct diagnosis.