Bartolozzi Carlo, Crocetti Laura, Lencioni Riccardo, Cioni Dania, Della Pina Clotilde, Campani Daniela
Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplant and Advanced Technologies in Medicine, University of Pisa, Via Roma 67, 56125, Pisa, Italy.
Eur Radiol. 2007 Oct;17(10):2519-30. doi: 10.1007/s00330-007-0602-5. Epub 2007 Feb 16.
The development and progression of a hepatocellular carcinoma (HCC) in a chronically diseased liver, i.e., the carcinogenesis, comprise a multistep and long-term process. Morphologically, this process is associated with the presence of distinct nodular lesions in the liver that are called 'preneoplastic lesions.' These preneoplastic lesions are associated with and can precede the growth and progression of well-differentiated HCCs . The characterization of nodular lesions and demonstration of the multistep development of HCC in the cirrhotic liver by imaging modalities represent a challenging issue. The arterial hypervascular supply, depicted by different dynamic studies, represents a fundamental radiological criterion for the diagnosis of HCC in cirrhosis. Magnetic resonance (MR) imaging performed with tissue-specific contrast media can help to investigate the "grey area" of carcinogenesis, in which significant histological changes are already present without any imaging evidence of neoangiogenesis. The purpose of this review is to provide information on the properties of tissue-specific MR contrast agents and on their usefulness in the demonstration of the pathologic changes that take place at the level of the biliary and reticuloendothelial systems during the carcinogenetic process in liver cirrhosis.
在慢性病变肝脏中肝细胞癌（HCC）的发生和发展，即致癌作用，是一个多步骤的长期过程。从形态学上讲，这个过程与肝脏中存在的被称为“癌前病变”的明显结节性病变有关。这些癌前病变与高分化HCC的生长和进展相关且可能先于其出现。通过成像方式对结节性病变进行表征以及证明肝硬化肝脏中HCC的多步骤发展是一个具有挑战性的问题。不同动态研究显示的动脉血供增加是肝硬化中HCC诊断的一项基本放射学标准。使用组织特异性对比剂进行的磁共振（MR）成像有助于研究致癌作用的“灰色区域”，在该区域中已经存在显著的组织学变化，但没有任何新血管生成的成像证据。本综述的目的是提供有关组织特异性MR对比剂的特性及其在显示肝硬化致癌过程中胆管和网状内皮系统水平发生的病理变化方面的有用性的信息。
