共查询到20条相似文献,搜索用时 46 毫秒
1.
Dysplastic nodules of the liver: imaging findings 总被引:2,自引:0,他引:2
Background: To verify characteristic features of hepatic dysplastic nodules at different imaging modalities.
Methods: Twenty-eight patients with 37 dysplastic nodules of the liver (0.8–3.0 cm) underwent sonography (28 patients), computed tomography
(CT; 24 patients), magnetic resonance (MR; 11 patients), and angiography (12 patients). Each nodule was analyzed for echogenicity,
attenuation, signal intensity, and vascularity.
Results: Echogenicity of nodules was high in 16 (43%), homogeneous in two (6%), and low in 19 (51%) of 37 nodules. Attenuation of
nodules was high in one (7%), homogeneous in four (26%), and low in 10 (67%) of 15 nodules on the arterial-phase CT images;
homogeneous in five (33%) and low in 10 (67%) of 15 nodules on the portal-phase CT images; and high in four (17%), homogeneous
in six (26%), and low in 13 (57%) of 23 nodules on the delayed-phase CT images. Signal intensity of nodules was high in 15
(94%) and homogeneous in one (6%) of 16 nodules on T1-weighted MR images and was homogeneous in seven (44%) and low in nine
(56%) of 16 nodules on T2-weighted MR images. Vascularity of nodules was avascular in 14 (88%) and slightly vascular in two
(12%) of 16 nodules.
Conclusions: Hepatic dysplastic nodules show diverse imaging characteristics with different imaging techniques; however, common imaging
findings of hepatic dysplastic nodules are low echo, low attenuation, and high, low, or homogeneous intensity on T1- and T2-weighted
MR, and avascularity.
Received: 13 May 1998/Accepted: 1 July 1998 相似文献
2.
Y. Yamashita H. Yamamoto A. Hirai S. Yoshimatsu Y. Baba M. Takahashi 《Abdominal imaging》1996,21(4):318-323
Purpose: To analyze the influence of liver dysfunction and parenchymal pathology on the accumulation of superparamagnetic iron oxide
(SPIO).
Methods: We evaluated MR images of 13 patients having small hepatic neoplasms before and after administration of SPIO (10 μmol/kg).
Biopsy and laboratory data confirmed the presence of severe cirrhosis in two patients, mild cirrhosis in four, chronic hepatitis
in five, and normal livers in two. Degrees of liver dysfunction or liver parenchymal pathology were correlated with reductions
in signal intensity of the liver and spleen after administration of SPIO. Signal intensity reduction was evaluated using a
1.5 Tesla MR unit.
Results: Response to SPIO of the liver and spleen did not correlate with liver parenchymal pathology, although reductions in signal
intensity of the liver were somewhat small in severely cirrhotic livers. There were slight correlations between signal intensity
alterations of the liver and laboratory data such as the indocyanine green retention rate (correlation coefficient 0.47),
albumin (0.36), total bilirubin (0.36), and serum glutamic oxaloacetic transaminase (GOT) (0.46). Signal intensity reduction
of spleen did not correlate with liver function tests except for serum GOT. In patients with cirrhosis, heterogeneous structures
were detected in the nontumorous portions of the liver. However, these did not prevent the diagnosis of small hepatomas.
Conclusion: The uptake of SPIO showed some correlation with liver function but not with chronic liver parenchymal pathology. SPIO provided
sufficient contrast between tumor and surrounding liver parenchyma among patients with chronic liver disease.
Received: 22 August 1994/Accepted after revision: 27 January 1995 相似文献
3.
Dynamic enhancement of upper abdominal organs in normal volunteers with MRI and effects of contrast dose reduction 总被引:3,自引:0,他引:3
Background: To quantify enhancement parameters of the upper abdominal organs over time during magnetic resonance (MR) examinations and
to evaluate the effect of a dose reduction of contrast medium on these parameters.
Methods: Ten volunteers underwent two separate dynamic enhanced MR examinations with 0.1 and 0.075 mmol/kg of contrast medium, respectively.
Breath-hold gradient-echo T1-weighted images were acquired every second for 118 s followed by delayed images. The percentages
of enhancement, the time to maximum enhancement, and the area under the time-versus-enhancement curve were calculated for
each organ.
Results: The mean times to maximum percentage of enhancement were less than 25 s for the pancreas, kidneys, and spleen and 50 s for
the liver. The mean values of maximum percentage of enhancement for the standard/reduced doses were 72%/62% (pancreas), 165%/155%
(kidneys), 114%/87% (spleen), and 67%/53% (liver). This difference was significant when liver enhancement was considered (p= 0.02). In addition, when the areas under the time-versus-enhancement curves were compared, the difference between the standard
dose and reduced dose was significant for all organs tested (p < 0.05).
Conclusions: Dynamic scanning of the upper abdomen should start early after contrast injection. Injection parameters should be standardized
to capture arterial and venous enhancements in liver examinations. A 25% dose reduction did not significantly affect peak
enhancement (except for the liver) but did significantly reduce overall enhancement.
Received: 8 September 1998/Revision accepted: 13 January 1999 相似文献
4.
Diffusion-weighted MR imaging with single-shot echo-planar imaging in the upper abdomen: preliminary clinical experience in 61 patients 总被引:48,自引:0,他引:48
Background: To determine the potential ability of diffusion-weighted magnetic resonance (MR) imaging with single-shot echo-planar imaging
(DW imaging) in the upper abdomen by apparent diffusion coefficient (ADC) and signal:intensity ratio (SIR) measurements.
Methods: DW imaging was performed in 61 clinical patients. ADCs in the liver, pancreas, spleen, kidney, and different pathological
conditions were calculated. Spleen-to-liver SIR and segmental intensity difference of the liver (SID) were also calculated.
Results: The mean ADCs (mm2/s) were 2.28 × 10−3± 0.07 in the liver, 1.44 × 10−3± 0.05 in the spleen, 1.94 × 10−3± 0.19 in the pancreas, and 5.76 × 10−3± 0.06 in the kidney. The mean ADC of cirrhotic liver was 1.96 × 10−3± 0.62, which was lower than that of normal liver. Other pathologic conditions also showed ADCs different from those of normal
tissues. All DW images showed significantly higher spleen-to-liver SIRs and SIDs than did T2-weighted images (p < 0.05).
Conclusion: The mean ADCs obtained with DW imaging were different in each upper abdominal organ and with each pathologic condition. DW
images showed better soft tissue contrast than did T2-weighted images with regard to SIR and CNR in depicting and characterizing
upper abdominal disorders.
Received: 24 July 1998/Revision accepted: 2 December 1998 相似文献
5.
M. Kanematsu H. Hoshi T. Yamada T. Murakami T. Kim M. Kato R. Yokoyama H. Nakamura 《Abdominal imaging》1999,24(1):47-55
Purpose: The purpose of this study was to assess the imaging findings of pathologically-proved small hepatic nodules 2 cm in size
or smaller detected with ultrasonography in cirrhotic patients with suspected hepatocellular carcinoma (HCC).
Materials and Methods: We evaluated sonographically detected 32 small hepatic nodules which were pathologically confirmed in 23 consecutive cirrhotic
patients who were suspected of having HCC. Twenty-six lesions were confirmed with ultrasonographically-guided aspiration needle-core
biopsy, and six with definitive surgery. Ultrasonographic examination records were retrospectively reviewed. CT, and MR images
obtained with various imaging techniques were retrospectively reviewed by two radiologists in a blind fashion.
Results: The 32 hepatic nodules were comprised of seven focal fatty changes, two large regenerative nodules, three low-grade dysplastic
nodules, five high-grade dysplastic nodules, and fifteen HCCs. Ultrasonography showed various echogenicity for the hepatic
nodules. The signal-intensity characteristics with T1-weighted spin-echo, in-phase gradient-recalled-echo, and dynamic MR
imagings may be useful in distinguishing HCC from nonHCC nodules.
Conclusions: Nearly half of small hepatic nodules detected with ultrasonography were nonHCC nodules. Ultrasonographic findings may not
be reliable in characterizing small hepatic nodules in cirrhosis. CT and MR imaging obtained with the various techniques are
still insensitive to these hepatic nodules.
RID="ID="<e5>Correspondence to:</e5> M. Kanematsu
Received: 25 August 1997/Revision accepted: 19 November 1997 相似文献
6.
Detection of lymph-node metastases in patients with gastric carcinoma: comparison of three MR imaging pulse sequences 总被引:9,自引:0,他引:9
Kato M Saji S Kanematsu M Fukada D Miya K Umemoto T Kunieda K Sugiyama Y Takao H Kawaguchi Y Takagi Y Kondo H Hoshi H 《Abdominal imaging》2000,25(1):25-29
Background: To compare the diagnostic accuracy of magnetic resonance (MR) images obtained with three different pulse sequences for lymph-node
metastases in patients with gastric cancer.
Methods: T1-weighted spin-echo (SE), breath-hold T2-weighted fast SE, and triphasic gadolinium-enhanced dynamic gradient-recall-echo
(GRE) MR images obtained in 16 patients with gastric carcinoma were retrospectively reviewed. Regional lymph nodes were assigned
to four different groups, and image review was conducted on a lymph-node group-by-group basis; 64 lymph-node groups were reviewed
by two radiologists. Relative sensitivity, specificity, and accuracy were determined based on the findings with definitive
surgery and follow-up imaging. Diagnostic accuracy was determined by means of receiver-operating-characteristic (ROC) analysis.
Results: Relative sensitivities for lymph-node metastases with T1-weighted SE, breath-hold T2-weighted fast SE, and dynamic GRE images
were 61%, 94%, and 59%, respectively. Relative sensitivity with breath-hold T2-weighted fast SE images was significantly greater
than that with T1-weighted SE (p < 0.05) and dynamic GRE (p < 0.05) images. Diagnostic accuracy determined by ROC analysis was marginally higher with breath-hold T2-weighted fast SE (area under
ROC curve [Az]= 0.87) than with T1-weighted SE (Az = 0.78, p= 0.08) and dynamic GRE (Az = 0.79, p= 0.12) images.
Conclusion: Breath-hold T2-weighted fast SE sequence is useful in the detection of regional lymph-node metastases in patients with gastric
carcinoma.
Received: 11 November 1998/Revision accepted: 7 April 1999 相似文献
7.
Arbab AS Ichikawa T Araki T Toyama K Nambu A Ohsawa S Kumagai H Aikawa Y 《Abdominal imaging》2000,25(2):151-158
Background: To identify the most useful combinations of various pre- and postcontrast magnetic resonance (MR) image sequences in detecting
hepatocellular carcinoma (HCC) and its intrahepatic metastases before and after injection of SHU-555-A.
Methods: Thirty-eight lesions in 16 patients were evaluated before and after administration of SHU-555-A by using fast spin echo (FSE),
gradient echo (GRE), and echo planar (EP) imaging sequences using a 1.5-Tesla superconducting MR system. The signal intensity
ratio (SIR) and contrast-to-noise ratio (CNR) of the lesions, signal-to-noise ratios, and other parameters were calculated.
Results: Tumors were better detected after injection of SHU-555-A on all pulse sequences except on out-of-phase T1-weighted (T1W)-GRE
sequences. Tumor detectability was higher for precontrast EP imaging and T2*-weighted (T2*W)-GRE sequences, whereas detectability
at postcontrast was higher for T2*W-GRE, proton-density-weighted-FSE, and in-phase T1W-GRE sequences. The SIR and CNR at precontrast
were highest for EP imaging, and those at postcontrast were highest for T2*W-GRE.
Conclusion: SHU-555-A will increase the detectability of HCC and its liver metastases. T1W- and T2*W-GRE sequences would be the sequences
of choice.
Received: 21 December 1998/Revision accepted: 5 May 1999 相似文献
8.
Hepatic parenchymal enhancement in the cirrhotic liver: evaluation by triple-phase dynamic MRI 总被引:7,自引:0,他引:7
Background: To evaluate the changes of liver parenchymal enhancement in the cirrhotic liver by means of triple-phase dynamic magnetic
resonance (MR) imaging.
Methods: Triple-phase multisection dynamic MR imaging was performed in 32 patients with liver cirrhosis. The control group consisted
of 19 patients without liver cirrhosis. After precontrast images were obtained, arterial phase images were acquired 20 s after
the start of intravenous bolus administration of 0.10 mmol/kg of gadopentetate dimeglumine. Portal and delayed phase images
were then acquired 1 and 3 min, respectively, after the injection of contrast material. On each phase image, the signal-to-noise
ratio (S/N) from the liver parenchyma was measured by operator-defined regions of interest (ROIs). The contrast-enhanced ratio
(CER) on each phase was then obtained according to the following formula: [S/N(arterial or portal or delayed phase image)
− S/N(precontrast image)]÷ S/N(precontrast image). The portal perfusion index (PPI) also was obtained according to the following
formula: [S/N(portal phase image − S/N(arterial phase image)]÷ S/N(arterial phase image). The results were expressed as mean
± SD.
Results: The CERs of arterial, portal, and delayed phase images in patients with and without liver cirrhosis were 0.256 ± 0.211, 0.640
± 0.384, and 0.554 ± 0.318 and 0.132 ± 0.094, 0.404 ± 0.204, and 0.324 ± 0.144, respectively. The CERs were highest in the
portal phase and lowest in the arterial phase in patients with and without liver cirrhosis. The CER of the cirrhotic liver
was significantly higher than that of the normal liver in every phase (p < 0.05). PPIs with and without liver cirrhosis were 2.90 ± 4.03 and 3.86 ± 3.89, respectively. The PPI with liver cirrhosis was
significantly lower than that without liver cirrhosis (p < 0.05).
Conclusion: The enhancement of cirrhotic liver parenchyma is greater than that of the normal liver parenchyma at every phase of triple-phase
dynamic MR imaging.
Received: 17 August 2000/Revision accepted: 7 March 2001 相似文献
9.
Small hepatocellular carcinoma: differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging 总被引:4,自引:0,他引:4
Background: To investigate the usefulness of color Doppler ultrasound (US) and dynamic Gd-DTPA-enhanced magnetic resonance (MR) imaging
in the differentiation of small hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH).
Methods: Thirty-eight small (3 cm or less) nodular lesions (in 38 cirrhotic patients) with US features consistent with HCC underwent
evaluation with color Doppler US and MR imaging. Breath-hold T1-weighted rapid acquisition spin echo MR sequence after bolus
injection of 0.1 mmol/kg gadopentetate dimeglumine was used to evaluate dynamic enhancement. US-guided tissue-core percutaneous
biopsy established the diagnosis: HCC in 28 cases and AH in 10.
Results: Color signals with pulsatile or continuous Doppler spectrum were demonstrated in 19 of 28 HCCs (68%) but in none of the AHs.
Although there was considerable overlap in signal intensity between HCC and AH on both unenhanced T1- and T2-weighted images,
early enhancement on breath-hold T1-weighted images obtained 40 s after starting contrast administration was observed in 22
of 28 HCCs (79%) but in none of the AHs. In 26 of 28 HCCs (93%), pulsatile or continuous flow at color Doppler US, early enhancement
at dynamic MR imaging, or both were observed.
Conclusion: Findings with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging enable a reliable distinction between small HCC and
AH.
Received: 8 August 1994/Accepted after revision: 27 January 1995 相似文献
10.
Fan-shaped hepatic parenchymal damage after ethanol injection therapy for hepatocellular carcinoma: MRI appearances 总被引:2,自引:0,他引:2
T. Fujita K. Honjo K. Ito T. Arita S. Koike K. Takano S. Tamura T. Matsumoto N. Matsunaga 《Abdominal imaging》1999,24(1):56-60
Background: T1- and T2-weighted magnetic resonance (MR) images frequently show fan-shaped areas of hypo- or hyperintensity in the hepatic
parenchyma adjacent to a treated hepatocellular carcinoma after percutaneous ethanol injection (PEI) therapy. These areas
correspond to abnormal contrast enhancement on serial dynamic MR images. The purpose of the present study was to describe
the location, appearance, and frequency of these abnormalities because it is important to understand these entities for the
correct assessment of therapeutic efficacy.
Methods: MR imaging including a multisection dynamic study was performed in 20 consecutive patients with hepatocellular carcinoma
treated with PEI therapy. We retrospectively evaluated the presence of fan-shaped hypointensities adjacent to treated tumors
in the liver parenchyma on T1-weighted images and hyperintensities on T2-weighted images and corresponding fan-shaped contrast
enhancement on both arterial-dominant and delayed-phase dynamic MR images. We review the location, appearance, and frequency
of these findings, and we discuss the possible causes on the basis of pathologic examinations.
Results: Seven (35%) of the 20 patients showed fan-shaped hyperintense areas adjacent to the treated tumors on T2-weighted images.
These areas showed isointensity in five patients and hypointensity in two patients on T1-weighted images. Of these seven patients,
one (14%) underwent the MR imaging within 1 month after the completion of PEI therapy, and six (86%) had it 2–9 months after
the completion of PEI therapy (mean = 6 months). In all seven patients, fan-shaped hyperperfusion abnormalities corresponding
to these areas of hyperintensity on T2-weighted images were seen on both arterial-dominant and delayed-phase dynamic MR images.
Pathologically, the coagulative necrosis of the hepatocytes with sinusoidal dilatation and the restoration by the development
of fibrous tissue were seen in these fan-shaped areas.
Conclusion: The fan-shaped areas of abnormal intensity on T1- and T2-weighted images and contrast enhancement on dynamic MR images seem
to be attributable to pathologic changes in the normal liver parenchyma induced by the toxic reaction of ethanol. Awareness
of the occurrence of such abnormalities in the peripheral liver parenchyma adjacent to the treated tumor is important for
the correct assessment of therapeutic efficacy.
RID="ID="<e5>Correspondence to:</e5> T. Fujita
Received: 24 June 1997/Accepted after revision: 22 October 1997 相似文献
11.
T. C. L. Soong R. C. Lee H. C. Cheng J. H. Chiang H. S. Tseng C. W. Lin M. M. H. Teng 《Abdominal imaging》1998,23(5):515-519
Background: To report the dynamic magnetic resonance (MR) imaging findings of hepatolithiasis.
Methods: Dynamic MR images (fast spoiled gradient echo sequence with intravenous injection of gadopentate dimeglumine) and computed
tomography, cholangiography, or angiography of nine patients with hepatolithiasis are analyzed.
Results: All affected hepatic segments showed atrophic changes and contained dilated intrahepatic ducts. These segments showed either
iso- or hypointensity on T1-weighted imaging and hyperintensity on T2-weighted imaging. Preferential enhancement was noted
throughout all phases of the dynamic study and persisted to delayed T1-weighted imaging in seven patients. In the last two
patients, severe atrophic changes made evaluating signal intensity differences and enhancement patterns difficult.
Conclusion: In addition to intrahepatic stones and biliary dilatation, segmental atrophy, signal intensity differences, and preferential
and persistent enhancement are important MR findings of hepatolithiasis.
Received: 18 June 1997/Accepted: 23 July 1997 相似文献
12.
Nodular regenerative hyperplasia of the liver in Budd–Chiari syndrome: CT and MR features 总被引:1,自引:0,他引:1
We report the imaging findings of spiral computed tomography (CT), magnetic resonance (MR) imaging, and MR angiography in
a patient with nodular regenerative hyperplasia of the liver associated with Budd–Chiari syndrome. Spiral CT showed multiple
enhancing nodules during the hepatic arterial and portal venous phases. MR images showed multiple hyperintense nodules on
T1-weighted images and hypointense or isointense nodules on T2-weighted images. MR angiography showed thrombotic occlusion
of three hepatic veins, suggesting Budd–Chiari syndrome.
Received: 25 June 1999/Revision accepted: 22 September 1999 相似文献
13.
Optimal phases of dynamic CT for detecting hepatocellular carcinoma: evaluation of unenhanced and triple-phase images 总被引:21,自引:0,他引:21
T. Kim T. Murakami S. Takahashi K. Tsuda K. Tomoda Y. Narumi H. Oi M. Sakon H. Nakamura 《Abdominal imaging》1999,24(5):473-480
Background: To determine the optimal phases of dynamic computed tomography (CT) for detecting hepatocellular carcinoma (HCC).
Methods: Fifty-two patients with 85 HCC nodules were examined by means of unenhanced and triple-phase CT images of the whole liver.
The time for obtaining the arterial-phase images was 25–55 s after intravenous bolus injection of contrast material, the time
for obtaining the portal venous-phase images was 65–100 s, and the time for obtaining late-phase images was 145 s to 4 min.
Detectability of the HCC nodules for all phases was statistically compared.
Results: The detection rates for the arterial- and late-phase images were significantly higher than for the unenhanced and portal
venous-phase images (p < 0.01). The combination of arterial- and late-phase images showed the same number of HCC nodules in the same number of patients
as did the combination of unenhanced and triple-phase images.
Conclusion: The combination of the arterial- and late-phase imagings was best for detecting HCC nodules.
Received: 8 July 1998/Revision accepted: 18 November 1998 相似文献
14.
Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns 总被引:5,自引:0,他引:5
Background: To categorize the helical computed tomographic (CT) intrahepatic recurrence patterns of hepatocellular carcinoma (HCC) after
treatment with percutaneous ablation procedures.
Methods: Double-phase helical CT studies of 67 patients with HCC recurrence were reviewed. The study population had undergone percutaneous
ablation therapy procedures (multisession or single-session ethanol injection therapy, radiofrequency thermal ablation therapy,
and interstitial laser photocoagulation therapy) for 120 HCC nodules.
Results: Four patterns were defined. (A) Enhancing tissue within the edge of the ablated nodule on arterial phase images (ingrowth):
this pattern was seen in five treated lesions (4.2% of all treated nodules) in five patients (7.5% of all patients with recurrence)
3–7 months after treatment (mean = 4 months). (B) Enhancing tissue around the treated nodule but continuously to its border
on arterial-phase images (outgrowth): this pattern was found in 12 (10%) treated lesions in 12 patients (18%) 3–6 months after
ablation (mean = 4 months). (C) Enhancing tissue within the same segment of the treated nodule on arterial phase images (spread):
this pattern was detected in 10 (8%) treated lesions in 10 patients (15%) 3–6 months after treatment (mean = 5 months). (D)
Enhancing tissue within different segments from the treated nodule on arterial phase images (progression): this pattern was
identified in 34 patients (51%) with 53 (44%) treated tumors 5–22 months after ablation (mean = 8 months). A mixed pattern
was found in six subjects (9%) with seven (6%) treated nodules. Among the 61 patients with a nonmixed pattern, there were
85 treated nodules with persistent necrosis, 17 treated nodules with local recurrence (pattern A or B), and 107 new nodules
due to nonlocal recurrence (pattern C or D). Portal phase enhanced images and especially unenhanced images showed a lower
detection rate and a lower lesion-to-liver conspicuity score (for all patterns but mainly for pattern C).
Conclusion: Four patterns of recurrence after percutaneous ablation procedures can be categorized on double-phase helical CT and are
best depicted on arterial phase images. Knowledge of these patterns is relevant for early detection and may be helpful in
understanding the recurrence mechanism.
Received: 25 September 2000/Accepted: 15 November 2000 相似文献
15.
B. Skikne D. Fonzo S. R. Lynch J. D. Cook 《European journal of clinical investigation》1997,27(3):228-233
The bioavailability of ferritin iron was evaluated in human subjects using radiolabelled [55Fe]ferritin isolated from bovine spleen and liver. Preliminary studies with bovine spleen ferritin labelled in vitro demonstrated an inappropriately high absorption compared with ferritin labelled in vivo, and the latter was therefore used in all subsequent absorption studies. In 10 subjects, geometric mean absorption from 5 mg of ferritin iron was 3.8% when taken without and 3.2% when taken with food (P >0.05). These values were significantly lower than absorption from the same dose of iron given as ferrous sulphate, which averaged 24.1% without and 8.2% with food. When the iron dose was increased 10-fold, absorption of ferritin iron averaged only 0.6–0.7% with or without food as compared with 7.9% without and 2.6% with food when the iron was given as ferrous sulphate. In a further study, mean absorption from bovine spleen ferritin of 4.0% did not differ significantly from the mean of 2.7% observed with bovine liver ferritin. These findings confirm previous studies indicating that ferritin iron is poorly absorbed. Furthermore, its use as a pharmaceutical iron preparation cannot be advocated. 相似文献
16.
Plain and gadolinium-DTPA-enhanced MR imaging of hepatocellular carcinoma treated with transarterial chemoembolization 总被引:12,自引:0,他引:12
M. Castrucci S. Sironi F. De Cobelli M. Salvioni A. Del Maschio 《Abdominal imaging》1996,21(6):488-494
Background: To assess unenhanced and gadolinium-enhanced magnetic resonance (MR) imaging patterns of hepatocellular carcinoma (HCC) treated
with transarterial chemoembolization (TACE).
Methods: Thirty-two patients with 48 HCC lesions underwent MR imaging before and 15 days after TACE. Fifteen lesions were then surgically
resected. The remaining 33 lesions were not removed and were followed up with MR imaging at 3, 6, 12, and 18 months after
treatment. Spin echo (SE) T1- and T2-weighted and gadolinium-enhanced SE T1-weighted sequences were employed. Qualitative
evaluation of signal intensity pattern of the treated lesions was performed in all cases. Histological evaluation and selective
hepatic arteriography were considered the gold standard of the study for the 15 resected lesions and the 33 unresected lesions,
respectively.
Results: On follow-up enhanced T1-weighted images of the 15 resected lesions, seven showed no area of enhancement corresponding to
complete necrosis at histologic examination. The remaining eight resected lesions showed areas of enhancement; in six of these
cases, viable tumor tissue was found at histology; in the other two lesions, histologic examination revealed the presence
of complete tumor necrosis. In the group of resected lesions, T2-weighted images showed no pattern characteristic of necrosis.
In 24 of 33 unresected lesions, loss of enhancement on follow-up enhanced T1-weighted images was a characteristic finding,
which correlated to devascularization at arteriography. Of these 24 lesions, 17 were completely hypointense on follow-up T2-weighted
images; the remaining seven showed small foci of hyperintensity. The other nine unresected lesions showed enhanced portions
on follow-up enhanced T1-weighted images, which corresponded to hyperintense areas on T2-weighted images. These findings correlated
to persistence of hypervascular areas at arteriography.
Conclusion: Gadolinium-enhanced T1-weighted MR imaging is a reliable method for evaluating the outcome of TACE treatment and is more
accurate than unenhanced T2-weighted MR imaging.
Received: 2 June 1995/Accepted: 18 July 1995 相似文献
17.
Ishida H Konno K Ishida J Naganuma H Komatsuda T Sato M Watanabe S 《Abdominal imaging》2001,26(5):529-532
Background and Methods: Lymphoma can be nearly anechoic and mimic a cyst on ultrasonography (US). To investigate whether this phenomenon occurs at
the level of the spleen, we analyzed the US findings of 38 cases of splenic lymphoma and 16 cases of splenic cyst.
Results: (1) With regard to shape, echogenicity of the lesion, and mode of posterior echo, there was no difference between splenic
lymphomas and splenic cysts. However, the boundaries of the lesions were indistinct in splenic lymphomas and distinct in splenic
cysts. (2) Blood flow signals and vascular penetration were seen exclusively in splenic lymphomas.
Conclusion: The mode of boundary echo (distinct or indistinct) distinguishes splenic lymphomas from splenic cysts. Color Doppler US increases
the diagnostic confidence of US.
Received: 25 September 2000/Revision accepted: 27 December 2000 相似文献
18.
Struma ovarii: appearance on MR images 总被引:2,自引:0,他引:2
I. Joja T. Asakawa A. Mitsumori T. Nakagawa Y. Hiraki T. Kudo M. Ando N. Akamatsu 《Abdominal imaging》1998,23(6):652-656
Background: The purpose of this multi-institutional study was to examine the appearance of struma ovarii on magnetic resonance (MR) images.
Methods: MR images of 12 patients with histologically proven struma ovarii were retrospectively reviewed. All patients underwent T1-weighted
and T2-weighted imaging. Contrast-enhanced T1-weighted images with Gd-DTPA were available in 10 patients. The following determinations
were made: tumor morphology, signal intensities, contrast-enhancement effects of solid components with Gd-DTPA, and comparison
of MR images with resected specimens.
Results: All 12 patients had both cystic and solid components, with a multilobulated surface and thickened septa. Signal intensities
on T1-weighted images were mainly low, partly intermediate to high, or high, and those on T2-weighted images were mainly high,
with different signal intensities. Contrast-enhancement effects were marked or moderate. The contents that showed low signal
intensities on T1-weighted images and signal voids or low signal intensities on T2-weighted images were viscid gelatinous
materials.
Conclusions: A multicystic tumor with a solid component, a multilobulated surface, and signal intensities that indicate the presence of
viscid gelatinous materials appear to be a characteristic MR finding of struma ovarii.
Received: 10 April 1997/Accepted after revision: 7 July 1997 相似文献
19.
J. F. Schlund R. C. Semelka U. Kettritz S. M. Weeks M. Kahlenberg W. G. Cance 《Abdominal imaging》1996,21(1):49-52
Background: The purpose of this study was to evaluate patients with wedge-shaped perfusion defects seen on spiral CT arterial portography
for the presence of transient increased wedge-shaped enhancement on dynamic gadolinium-enhanced gradient echo MR images.
Methods: Nineteen patients underwent CTAP and MRI within a 2-week interval. All patients with wedge-shaped perfusion defects on CT
arterial portography were evaluated in a separate review session for the presence of transient increased segmental hepatic
enhancement on dynamic gadolinium-enhanced spoiled gradient echo (SGE) MR images.
Results: Eight patients were identified to have subsegmental, segmental, or lobar wedge-shaped perfusion defects by CT arterial portography.
In 8/8 patients, there was transient wedge-shaped increased hepatic enhancement on MR images which corresponded to the perfusion
defects identified on CT arterial portography. Transient increased enhancement on MR images was observed on immediate postgadolinium
images as high-signal intensity of the involved subsegment, segment, or lobe. This relatively high-signal area faded to near
isointensity in all cases on images obtained at 45 s.
Conclusion: Wedge-shaped perfusion defects demonstrated by CT arterial portography corresponded to wedge-shaped increased hepatic enhancement
following gadolinium administration on SGE MR images.
Received: 29 December 1994/Accepted: 7 February 1995 相似文献
20.
Struma ovarii: MR appearances 总被引:1,自引:0,他引:1
Background: Analysis of unenhanced and contrast-enhanced magnetic resonance (MR) images of struma ovarii, a rare benign neoplasm of the
ovary, is the aim of this study.
Methods: T2-weighted and Gd-DTPA-enhanced T1-weighted MR images of five histologically proven struma ovarii were evaluated retrospectively.
Results: In all patients, unenhanced and contrast-enhanced T1-weighted MR images showed complex cystic masses composed of multiple
cysts and a solid component, indicating the presence of large and small thyroid follicles. In four patients, the cyst fluid
was hypointense on T1-weighted images and hyperintense on T2-weighted images. In one patient, the fluid was hyperintense on
T1-weighted images and hypointense on T2-weighted images due to hemorrhage.
Conclusion: A complex mass composed of multiple cysts and a solid component, indicating the presence of large and small thyroid follicles,
appeared to be a characteristic MR finding of struma ovarii.
Received: 11 December 1995/Accepted: 15 December 1995 相似文献