Weissleder R, Stark D D, Elizondo G, Hahn P F, Compton C, Saini S, Wittenberg J, Ferrucci J T
Department of Radiology, Massachusetts General Hospital, Boston 02114.
Magn Reson Imaging. 1988 Nov-Dec;6(6):675-81. doi: 10.1016/0730-725x(88)90092-6.
Thirteen patients with biopsy proven hepatic lymphoma (2 Hodgkin, 11 Non-Hodgkin) and a control group of 15 patients with hepatic metastases were analyzed quantitatively and qualitatively by MRI. Focal hepatic lymphoma was most reliably detected (eight of eight patients) and appeared hypointense relative to liver on T1 weighted (CNR - 7.4 +/- 2.3) and hyperintense on T2 weighted (CNR + 8.4 +/- 2.9) images. The mean T1 and T2 relaxation times of focal hepatic lymphoma (T1 = 832 +/- 234 msec, T2 = 84 +/- 16 ms) differed significantly from adjacent non-tumorous liver (T1 = 420 +/- 121 ms, T2 = 51 +/- 9 ms; p less than 0.05), however CNR values and relaxation times were similar to those of hepatic metastases. Diffuse hepatic lymphoma (microscopic periportal infiltration) was undetectable by MRI in three patients by either morphologic features or quantitative criteria. A mixed pattern of hepatic lymphoma (focal lesions and diffuse infiltration) showed focal areas of slightly decreased signal intensity on T1 weighted images (CNR = -1.7 +/- 0.4) while T2 weighted images revealed multiple regions of focal hyperintensity (CNR = +13.3 +/- 8.4) superimposed on a diffusely hyperintense liver. Our experience demonstrates that either T1 or T2 weighted techniques are useful in detecting focal and that T2 weighted techniques are useful in detecting mixed hepatic lymphoma. Conventional image derived relaxation time measurements and quantitative parameters were of no additional diagnostic value.
对13例经活检证实的肝淋巴瘤患者（2例霍奇金淋巴瘤，11例非霍奇金淋巴瘤）以及15例肝转移患者的对照组进行了MRI定量和定性分析。局灶性肝淋巴瘤最易被可靠检测到（8例患者中的8例），在T1加权像上相对于肝脏呈低信号（对比噪声比 - 7.4 ± 2.3），在T2加权像上呈高信号（对比噪声比 + 8.4 ± 2.9）。局灶性肝淋巴瘤的平均T1和T2弛豫时间（T1 = 832 ± 234毫秒，T2 = 84 ± 16毫秒）与相邻的非肿瘤性肝脏（T1 = 420 ± 121毫秒，T2 = 51 ± 9毫秒；p < 0.05）有显著差异，然而对比噪声比值和弛豫时间与肝转移瘤相似。3例弥漫性肝淋巴瘤（显微镜下门周浸润）通过MRI的形态学特征或定量标准均无法检测到。混合型肝淋巴瘤（局灶性病变和弥漫性浸润）在T1加权像上显示局灶性信号强度略有降低（对比噪声比 = -1.7 ± 0.4），而T2加权像显示多个局灶性高信号区域（对比噪声比 = +13.3 ± 8.4）叠加在弥漫性高信号的肝脏上。我们的经验表明，T1或T2加权技术在检测局灶性肝淋巴瘤方面有用，而T2加权技术在检测混合型肝淋巴瘤方面有用。传统的图像衍生弛豫时间测量和定量参数没有额外的诊断价值。
