Danet Ioana-Maria, Semelka Richard C, Nagase Larissa L, Woosely John T, Leonardou Polytimi, Armao Diane
Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7510, USA.
J Magn Reson Imaging. 2003 Aug;18(2):181-8. doi: 10.1002/jmri.10337.
To describe the magnetic resonance imaging spectrum of appearances of liver metastases from pancreatic ductal adenocarcinoma.
We retrospectively evaluated the MRI exams performed between July 1996 and August 2001 in all patients who had liver metastases from pancreatic adenocarcinoma and histopathologic diagnosis from either the primary pancreatic tumor, liver metastases, or both. Sixteen patients were included in the study. All MR studies were performed at 1.5 T with a standard protocol including T1- and T2-weighted images and serial post-gadolinium spoiled gradient echo (SGE) images. Location, size, number, signal characteristics on T1- and T2-weighted images, and pattern of enhancement on serial gadolinium-enhanced SGE images were assessed.
The diameter of metastases ranged from a few millimetres to 4 cm, and 12 patients (75%) had only lesions of 1.5 cm or less. Capsular-based liver metastases were found in 13 patients (81%) and three patients had only capsular-based lesions with a diameter under 1.5 cm. Hypervascular lesions were found in six patients (38%) and hypovascular lesions in 10 patients (62%). Perilesional enhancement was present in 10 patients (62%), with six patients (38%) having ring perilesional enhancement and eight patients (50%) having wedge-shaped perilesional enhancement.
On MR imaging, hepatic metastases from pancreatic adenocarcinoma show a range of enhancement patterns. Hypervascular metastases are not rare. Capsular based distribution, small diameter, and perilesional enhancement are common features. This retrospective study describes the MR imaging spectrum of appearances of liver metastases from pancreatic adenocarcinoma in patients with histopathologic confirmation of the diagnosis.
描述胰腺导管腺癌肝转移灶的磁共振成像表现谱。
我们回顾性评估了1996年7月至2001年8月期间对所有胰腺腺癌肝转移患者进行的MRI检查,这些患者均有原发性胰腺肿瘤、肝转移灶或两者的组织病理学诊断。16例患者纳入本研究。所有MR检查均在1.5T下进行,采用标准方案,包括T1加权和T2加权图像以及钆增强后连续扰相梯度回波(SGE)图像。评估转移灶的位置、大小、数量、T1加权和T2加权图像上的信号特征以及钆增强SGE连续图像上的强化模式。
转移灶直径从几毫米到4厘米不等,12例患者(75%)仅有直径1.5厘米或更小的病灶。13例患者(81%)发现有基于包膜的肝转移灶,3例患者仅有直径小于1.5厘米的基于包膜的病灶。6例患者(38%)发现有高血供病灶,10例患者(62%)发现有低血供病灶。10例患者(62%)出现病灶周围强化,6例患者(38%)出现环形病灶周围强化,8例患者(50%)出现楔形病灶周围强化。
在MR成像上,胰腺腺癌肝转移表现出多种强化模式。高血供转移灶并不罕见。基于包膜的分布、小直径和病灶周围强化是常见特征。这项回顾性研究描述了经组织病理学确诊的胰腺腺癌肝转移患者的MR成像表现谱。