Bruegel Melanie, Rummeny Ernst J
Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
Abdom Imaging. 2010 Aug;35(4):454-61. doi: 10.1007/s00261-009-9541-8. Epub 2009 May 27.
Diffusion-weighted MR imaging is increasingly applied to detect and characterize focal hepatic lesions. In this update article, technical aspects regarding diffusion-weighted echo-planar imaging (DW-EPI) of the liver will be addressed, and concepts for image interpretation will be provided. The value of DW-EPI for the detection of hepatic metastases is illustrated on the basis of a review of the literature and our personal experience. In this respect, special emphasis is given to the comparison of DW-EPI with well-established MR imaging techniques such as T2-weighted and contrast-enhanced MR imaging, and advantages and limitations of DW-EPI will be described. Based on the review, it is concluded that DW-EPI is more sensitive than T2-weighted MR imaging and at least as accurate as superparamagnetic iron oxide-enhanced or gadolinium-enhanced MR imaging for the detection of hepatic metastases. Although difficulties occasionally arise in further characterizing small lesions detected with DW-EPI, substantial improvements in the preoperative evaluation of liver metastases in candidates for hepatic resection may be expected.
扩散加权磁共振成像越来越多地用于检测和表征肝脏局灶性病变。在这篇更新文章中，将阐述肝脏扩散加权回波平面成像（DW-EPI）的技术方面，并提供图像解读的概念。基于文献综述和我们的个人经验，说明了DW-EPI在检测肝转移瘤方面的价值。在这方面，特别强调了DW-EPI与成熟的磁共振成像技术（如T2加权和对比增强磁共振成像）的比较，并将描述DW-EPI的优缺点。基于该综述得出结论，对于检测肝转移瘤，DW-EPI比T2加权磁共振成像更敏感，并且至少与超顺磁性氧化铁增强或钆增强磁共振成像一样准确。尽管在用DW-EPI检测到的小病变的进一步特征化方面偶尔会出现困难，但预计肝切除候选者肝转移瘤的术前评估会有实质性改善。
