Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703, Republic of Korea.
Eur J Radiol. 2012 Dec;81(12):3998-4004. doi: 10.1016/j.ejrad.2012.03.032. Epub 2012 Aug 22.
To determine specific imaging features of hepatic metastasis from colorectal cancer, focusing on the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI.
Over a 2-year period, 79 hepatic metastatic lesions were identified from 32 patients (22 men and 10 women) who proven colorectal cancer and underwent gadoxetic acid-enhanced 3.0T MRI. Hepatic metastases were proven pathologically in 16 patients: by surgical liver resection (n=14) and by US-guided biopsy (n=2). The remaining 16 patients were considered to have hepatic metastasis based on imaging studies and clinical information. Two radiologists evaluated the imaging features of each MRI sequence, including high resolution T2WI, dynamic contrast enhancement study with hepatobiliary phase, and diffusion weighted image. We also compared SI of the lesions on T2WI and HBP.
T2WI showed homogeneous high SI (n=25; 31.7%), target appearance (n=3; 3.8%), reversed target appearance (n=2; 2.6%), and heterogeneously high SI (n=49; 62%). On HBP, homogeneous defect were seen in 22 lesions (27.9%), target appearance in five lesions (6.4%), reversed target appearance in two lesions (2.5%), and heterogeneous defect in 50 lesions (63.3%); including reticular (70%), partially globular (26%), and diffuse GGO-like (4%) patterns. According to the imaging features on HBP, the homogeneous defect and heterogeneous defect groups had a mean ADC value of 0.99 × 10(-3) and 1.07 × 10(-3)mm(2)/s, respectively, without statistically significant difference.
Hepatic metastasis from colorectal cancer usually showed as a heterogeneous defect on HBP and a heterogeneous high SI on T2WI. The generally accepted "true defect" was not a common finding in hepatic metastasis from colorectal cancer.
探讨钆塞酸增强磁共振成像肝胆期（HBP）在结直肠癌肝转移成像特征中的作用。
回顾性分析 2012 年 1 月至 2014 年 1 月期间经病理证实的 32 例结直肠癌患者 79 个肝转移瘤的影像资料，男 22 例，女 10 例，均行 3.0T 磁共振肝胆特异对比剂（Gd-EOB-DTPA）增强扫描，包括高分辨率 T2WI、动态增强扫描及肝胆期，扩散加权成像。分析转移瘤在各序列的影像学特征，包括 T2WI 信号强度、HBP 强化方式、DWI 信号，比较 T2WI 及 HBP 病灶信号强度。
T2WI 呈均匀高信号 25 个（31.7%），靶征 3 个（3.8%），反靶征 2 个（2.6%），不均匀高信号 49 个（62.0%）。HBP 呈均匀低信号 22 个（27.9%），靶征 5 个（6.4%），反靶征 2 个（2.5%），不均匀低信号 50 个（63.3%），其中网状（70%），部分结节状（26%），地图样磨玻璃影（4%）。HBP 均匀低信号组及不均匀低信号组 ADC 值分别为 0.99×10(-3)、1.07×10(-3)mm(2)/s，差异无统计学意义（P＞0.05）。
结直肠癌肝转移瘤 HBP 多呈不均匀低信号，T2WI 呈不均匀高信号，“真正缺损”并不常见。
