Fang Jiayang, Ma Xiaoyuan, Yu Dexin, Ma Xiangxing, Xiang Ying, Guo Lijuan
Department of Radiology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Ji'nan City, Shandong, China, 250012.
Department of Orthopaedics, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Ji'nan City, China.
Eur Radiol. 2017 Sep;27(9):3563-3573. doi: 10.1007/s00330-017-4731-1. Epub 2017 Jan 25.
To obtain specific imaging findings of solitary necrotic nodule of the liver (SNNL) using longer delayed contrast-enhanced MRI and compare them with those of three mimic hepatic diseases.
Sixteen patients with SNNL underwent plain and contrast-enhanced triphasic CT and multiphasic MRI with delayed time prolonged to 2 h after contrast bolus injection. Twenty-three patients with mimic lesions including seven with eight HCCs, five with five iCCs and 11 with metastatic lesions served as the control group. Those patients also received plain and multiphasic contrast-enhanced MRI. Imaging features of lesions such as peripheral wash-out time were evaluated.
Among the 16 SNNLs, with a prolonged delayed MRI time, the enhancement degree of tumour periphery increased gradually. When it was up to 1 h, all lesions represented moderate/marked peripheral enhancement with internal hypointensity. However, the peripheral wash-out in seven HCCs (87.5%) and all metastatic lesions except three appeared at 10 or 15 min, one iCC (20%) at 30 min and the other lesions at 1 h.
Longer MRI with a delayed time of 1-2 h may be useful in diagnosis SNNL, revealing the specific imaging characteristic of SNNL as pronounced peripheral enhancement with internal hypointensity.
• Longer delayed MRI plays an important role in the diagnosis of SNNL. • Characteristic imaging feature of SNNL is pronounced peripheral enhancement with internal hypointensity. • Periphery wash-out time can differentiate SNNL from mimic diseases. • Imaging findings of SNNL on routine CT and MRI are unspecific.
采用更长延迟时间的对比增强磁共振成像（MRI）获取肝脏孤立性坏死结节（SNNL）的特异性影像学表现，并与三种肝脏疾病模拟病变的表现进行比较。
16例SNNL患者接受了平扫及对比增强三期CT检查，以及对比剂团注后延迟时间延长至2小时的多期相MRI检查。23例有模拟病变的患者作为对照组，其中包括7例有8个肝细胞癌（HCC）的患者、5例有5个肝内胆管癌（iCC）的患者和11例有转移瘤的患者。这些患者也接受了平扫及多期相对比增强MRI检查。评估病变的影像学特征，如周边廓清时间。
在16个SNNL中，随着MRI延迟时间延长，肿瘤周边强化程度逐渐增加。当延迟至1小时时，所有病变均表现为周边中度/明显强化，内部呈低信号。然而，7个HCC（87.5%）及除3个以外的所有转移瘤在10或15分钟时出现周边廓清，1个iCC（20%）在30分钟时出现周边廓清，其他病变在1小时时出现周边廓清。
延迟时间为1 - 2小时的更长时间MRI检查可能有助于SNNL的诊断，显示SNNL的特异性影像学特征为明显的周边强化伴内部低信号。
• 更长延迟时间的MRI在SNNL的诊断中起重要作用。• SNNL的特征性影像学表现为明显的周边强化伴内部低信号。• 周边廓清时间可将SNNL与模拟疾病区分开来。• SNNL在常规CT和MRI上的影像学表现不具有特异性。
