Suzuki Hiroshi, Tsurita Giichiro, Ishihara Soichiro, Akahane Masaaki, Kitayama Joji, Nagawa Hirokazu
Department of Surgical Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Case Rep Gastroenterol. 2008 Sep;2(3):509-16. doi: 10.1159/000183536. Epub 2008 Dec 10.
Extensive preoperative assessment of hepatic metastases is required in colon cancer patients. We report a case in whom the preoperative investigation by ultrasound scan and contrast-enhanced computed tomography revealed numerous cystic lesions of the liver, suspicious of von Meyenburg complex. Magnetic resonance and magnetic resonance cholangiographic images demonstrated typical features of von Meyenburg complex. Further Resovist-enhanced magnetic resonance imaging detected two hemangiomas in addition to the multiple cystic lesions. So-called Kupffer cell imaging strongly helped the detection of these hemangiomas, and a combination of various magnetic resonance pulse sequences was of great value for the differential diagnosis of cystic lesions and hemangiomas. In cases in whom conventional imaging studies fail to give a definite diagnosis, such as in the present case, superparamagnetic iron oxide-enhanced magnetic resonance imaging is meaningful for adequate preoperative staging.
结肠癌患者需要对肝转移进行全面的术前评估。我们报告一例病例,术前超声扫描和对比增强计算机断层扫描显示肝脏有许多囊性病变,怀疑为梅耶尔堡复合体。磁共振和磁共振胆管造影图像显示了梅耶尔堡复合体的典型特征。进一步的钆贝葡胺增强磁共振成像除了发现多个囊性病变外,还检测到两个肝血管瘤。所谓的库普弗细胞成像对这些肝血管瘤的检测有很大帮助,各种磁共振脉冲序列的组合对囊性病变和肝血管瘤的鉴别诊断具有重要价值。在传统影像学检查无法明确诊断的病例中,如本病例,超顺磁性氧化铁增强磁共振成像对于充分的术前分期具有重要意义。