Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, South Korea.
Magn Reson Imaging. 2010 Nov;28(9):1327-34. doi: 10.1016/j.mri.2010.06.013. Epub 2010 Aug 30.
The purpose of this study was to describe magnetic resonance (MR) findings of focal eosinophilic liver disease using gadoxetic acid (Gd-EOB-DTPA).
Nineteen patients (M:F=14:5; age range, 26-66 years; mean age, 50 years) with 35 focal eosinophilic liver lesions were included after reviewing the medical records of 482 patients who underwent Gd-EOB-DTPA-enhanced MR imaging (MRI) on a 3.0-T unit between April 2008 and June 2009. The diagnosis of focal eosinophilic liver disease was established by means of percutaneous liver biopsy or surgery and consistent clinical findings. Two radiologists retrospectively reviewed MR images with consensus. Margin, shape and distribution of the lesions were analyzed. We also evaluated signal intensity of focal hepatic lesions on T(1)- and T(2)-weighted images and patterns of enhancement in dynamic contrast study.
The mean diameter of the lesions was 1.7 cm (range, 0.7-6.1 cm). Most of the focal eosinophilic liver lesions [n=31/35 (88.6%)] had poorly defined margins. They were usually isointense or slightly hypointense [n=34/35 (97.2%)] on T(1)-weighted images and hyperintense [n=32/35 (91.4%)] on T(2)-weighted images. Dynamic study showed enhancement (rim or homogeneous) on the arterial phase [n=21/35 (60%)] and hypointensity on the late venous phase [n=31/35 (88.6%)]. All the lesions were hypointense on the hepatobiliary phase images.
Focal eosinophilic liver lesions tend to be hyperintense on the arterial phase and hypointense on the late venous phase during dynamic study of Gd-EOB-DTPA-enhanced MRI. Although these findings mimic other focal hepatic lesions, poorly defined margins of the lesions and peripheral eosinophilia might help distinguish focal eosinophilic liver disease from other hepatic lesions.
本研究旨在描述使用钆塞酸二钠（Gd-EOB-DTPA）进行磁共振成像（MRI）时局灶性嗜酸性肝病的 MRI 表现。
回顾性分析 2008 年 4 月至 2009 年 6 月期间在 3.0T 磁共振仪上进行 Gd-EOB-DTPA 增强 MRI 检查的 482 例患者的病历资料，选取其中 19 例（男 14 例，女 5 例；年龄 26~66 岁，平均年龄 50 岁）经皮肝活检或手术证实且临床表现相符的 35 个局灶性嗜酸性肝病病灶。由 2 名放射科医生进行回顾性分析，对病灶的边缘、形状和分布进行评估，并分析 T1 加权像和 T2 加权像上病灶的信号强度以及动态对比研究中的增强模式。
病灶的平均直径为 1.7cm（范围 0.7~6.1cm）。大多数局灶性嗜酸性肝病病灶[31/35（88.6%）]边界不清。T1 加权像上病灶多呈等信号或稍低信号[34/35（97.2%）]，T2 加权像上呈高信号[32/35（91.4%）]。动态研究显示动脉期呈强化（边缘或均匀）[21/35（60%）]，门静脉晚期呈低信号[31/35（88.6%）]。所有病灶在肝胆期均呈低信号。
在 Gd-EOB-DTPA 增强 MRI 动态研究中，局灶性嗜酸性肝病病灶在动脉期呈高信号，门静脉晚期呈低信号。虽然这些表现类似于其他局灶性肝病变，但病灶边界不清和外周嗜酸性粒细胞增多可能有助于将局灶性嗜酸性肝病与其他肝病变相鉴别。
