Ahn Sung Jun, Choi Jin-Young, Kim Kyung Ah, Kim Myeong-Jin, Baek Song-Ee, Kim Joo Hee, Song Ho-Taek
Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Korea.
J Comput Assist Tomogr. 2011 Jan-Feb;35(1):81-5. doi: 10.1097/RCT.0b013e3181f39f30.
Using gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI), the purpose of this study was to evaluate findings of focal hepatic eosinophilic infiltration.
This retrospective study included 8 patients with 7 histologically confirmed focal eosinophilic infiltration (FEI) of the liver. One case was considered as FEI by using clinical findings and follow-up imaging. Gadoxetic acid-enhanced MRI and DWI were reviewed by 2 radiologists. We evaluated the signal intensity of focal lesions on T1-weighted, T2-weighted, and DW images and the pattern of enhancement in arterial, portal, equilibrium, and hepatobiliary phases of the gadoxetic acid-enhanced MRI. Apparent diffusion coefficient (ADC) value for focal eosinophilic infiltration was also calculated.
On T2-weighted images, 7 (88%) of 8 cases (7/8 lesions) showed mixed hyperintensity with irregular margins. Six (75%) of the 8 cases showed rim enhancement in the arterial phase. Most cases (5/8 lesions [63%]) showed isointensity or hypointensity in the portal and equilibrium phases. In the hepatobiliary phase, all cases (8/8) showed mixed hypointensity with irregular margins and nonspherical shapes. All cases showed hyperintensity in both low and high b-value ranges on DWI. The ADCs for 6 cases showed less than 1.05 × 10(-3) mm2/s (0.74 × 10(-3) to 1.03 × 10(-3) mm2/s).
Focal eosinophilic infiltration showed mixed hypointensity, irregular margins, and nonspherical shapes with excellent lesion-to-liver contrast in the hepatobiliary phase of the gadoxetic acid-enhanced MRI. Diffusion-weighted imaging and ADCs may not be helpful for characterizing these benign hepatic lesions.
本研究旨在利用钆塞酸二钠增强磁共振成像（MRI）和扩散加权成像（DWI）评估局灶性肝嗜酸性粒细胞浸润的表现。
本回顾性研究纳入了8例患者，其中7例经组织学证实为肝脏局灶性嗜酸性粒细胞浸润（FEI）。1例通过临床表现和随访影像学检查被诊断为FEI。2名放射科医生对钆塞酸二钠增强MRI和DWI进行了评估。我们评估了局灶性病变在T1加权、T2加权和DW图像上的信号强度，以及钆塞酸二钠增强MRI动脉期、门脉期、平衡期和肝胆期的强化模式。还计算了局灶性嗜酸性粒细胞浸润的表观扩散系数（ADC）值。
在T2加权图像上，8例中的7例（88%，7/8个病灶）表现为边界不规则的混合高信号。8例中的6例（75%）在动脉期表现为边缘强化。大多数病例（5/8个病灶[63%]）在门脉期和平衡期表现为等信号或低信号。在肝胆期，所有病例（8/8）均表现为边界不规则、非球形的混合低信号。所有病例在DWI的低b值和高b值范围内均表现为高信号。6例的ADC值小于1.05×10(-3) mm2/s（0.74×10(-3)至1.03×10(-3) mm2/s）。
在钆塞酸二钠增强MRI的肝胆期，局灶性嗜酸性粒细胞浸润表现为混合低信号、边界不规则和非球形，病变与肝脏对比良好。扩散加权成像和ADC值可能无助于鉴别这些良性肝脏病变。
