肝血管瘤：弥散加权 MR 序列上 T2 穿透效应相关因素。
Hepatic hemangiomas: factors associated with T2 shine-through effect on diffusion-weighted MR sequences.
机构信息
Centre Hospitalier Universitaire Vaudois and University of Lausanne, Department of Radiology, Lausanne, Switzerland; Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy, France.
Assistance-Publique Hôpitaux de Paris, APHP, Hôpital Beaujon, Department of Radiology, Clichy, France; University Paris Diderot, Sorbonne Paris Cité, INSERM U773, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France.
出版信息
Eur J Radiol. 2014 Mar;83(3):468-78. doi: 10.1016/j.ejrad.2013.11.023. Epub 2013 Dec 4.
PURPOSE
To determine the frequency and factors associated with the presence of T2 shine-through effect in hepatic hemangiomas on diffusion-weighted (DW) magnetic resonance (MR) sequences.
MATERIALS AND METHODS
This retrospective study was approved by institutional review board with waiver of informed consent. One hundred forty-nine consecutive patients with 388 hepatic hemangiomas who underwent a liver MR between January 2010 and November 2011 were included. MR analysis evaluated the lesion characteristics (signal intensities and enhancement patterns (classical, rapidly filling, delayed filling)), the presence of T2 shine-through effect on DW sequences (b values of 0, 150, and 600 s/mm2), and apparent diffusion coefficient (ADC) values. Multivariate analysis was performed to study the factors associated with the T2 shine-through effect.
RESULTS
T2 shine-through effect was observed in 204/388 (52.6%) of hepatic hemangiomas and in 100 (67.1%) patients. Mean ADC value of hemangiomas with T2 shine-through effect was significantly lower than hemangiomas without (2.0±0.48 vs 2.38±0.45, P<.0001). On multivariate analysis, high signal intensity on fat-suppressed T2-weighted fast spin-echo images, hemangiomas with classical or delayed enhancement, and the ADC of the liver were the only significant factors associated with T2 shine-through effect.
CONCLUSION
T2 shine-through effect is commonly observed in hepatic hemangiomas and is related to hemangiomas characteristics. Radiologists should be aware of this phenomenon which could lead to misdiagnosis. Its presence should not question the diagnosis of hemangiomas when typical MR findings are found.
目的
确定扩散加权（DW）磁共振（MR）序列中肝血管瘤 T2 透射线效应的出现频率及其相关因素。
材料与方法
本回顾性研究经机构审查委员会批准，豁免知情同意。共纳入 2010 年 1 月至 2011 年 11 月期间行肝脏 MR 检查的 149 例连续患者，共 388 个肝血管瘤。MR 分析评估病变特征（信号强度和强化模式（经典型、快速填充型、延迟填充型））、DW 序列上 T2 透射线效应的存在（b 值分别为 0、150 和 600 s/mm2）和表观扩散系数（ADC）值。进行多变量分析以研究与 T2 透射线效应相关的因素。
结果
204/388（52.6%）个肝血管瘤和 100（67.1%）例患者中观察到 T2 透射线效应。T2 透射线效应的血管瘤 ADC 值明显低于无 T2 透射线效应的血管瘤（2.0±0.48 比 2.38±0.45，P<.0001）。多变量分析显示，T2 加权快速自旋回波脂肪抑制图像上的高信号强度、具有经典或延迟强化的血管瘤以及肝脏 ADC 是与 T2 透射线效应相关的唯一显著因素。
结论
T2 透射线效应在肝血管瘤中较为常见，与血管瘤特征相关。放射科医生应意识到这种现象可能导致误诊。当存在典型的 MR 表现时，其存在不应质疑血管瘤的诊断。
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