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类癌肝转移在肝胆期钆贝葡胺的非典型强化——病例报告

Atypical Enhancement of Gd-BOPTA on the Hepatobiliary Phase in Hepatic Metastasis from Carcinoid Tumor - Case Report.

作者信息

Pozowski Patryk, Misiak Paula, Szymańska Kinga, Mazur Rafał, Sierpowska Małgorzata, Silicki Jurand, Celmer Milena, Łasecki Mateusz, Pawluś Aleksander, Zaleska-Dorobisz Urszula

机构信息

Department of General and Pediatric Radiology, Wrocław Medical University, Wrocław, Poland.

University Teaching Hospital of Jan Mikulicz-Radecki in Wrocław, Wrocław, Poland.

出版信息

Am J Case Rep. 2020 Sep 4;21:e924280. doi: 10.12659/AJCR.924280.

DOI:10.12659/AJCR.924280
PMID:32883944
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7491956/
Abstract

BACKGROUND Carcinoid tumor is the most frequent neuroendocrine tumor (NET) that causes liver metastases. One of the best methods to assess this type of pathology is magnetic resonance imaging with hepatocyte-specific contrast media with low molecular weight gadolinium chelate Gd-BOPTA. As these lesions do not contain hepatocytes, they present as hypointense on MRI in comparison with liver tissue which enhances this type of contrast. CASE REPORT In this article, we present a case of a 65-year-old female patient who was admitted to the Emergency Department with abdominal pain. Computed tomography revealed a single focal lesion in her liver. The patient underwent further evaluation using magnetic resonance imaging (MRI). The hepatobiliary phase MRI showed an unspecific homogenous enhancement of the hepatobiliary agent Gd-BOPTA. Since the lesion was interpreted as a non-characteristic lesion, the patient was discharged from the hospital with a recommendation for early follow-up. The follow-up MRI 6 months after discharge disclosed multiple liver metastases. CONCLUSIONS Liver metastases generally demonstrate enhancement of hepatobiliary contrast agents in the T1-weighted hepatocellular phase. Metastasis from a carcinoid tumor may also demonstrate this enhancement.

摘要

背景 类癌瘤是导致肝转移的最常见神经内分泌肿瘤（NET）。评估这类病理情况的最佳方法之一是使用含低分子量钆螯合物钆贝葡胺的肝细胞特异性造影剂进行磁共振成像。由于这些病变不含肝细胞，与增强这类造影剂的肝组织相比，它们在磁共振成像上表现为低信号。病例报告 在本文中，我们介绍了一名65岁女性患者，她因腹痛入住急诊科。计算机断层扫描显示其肝脏有一个单一局灶性病变。患者接受了磁共振成像（MRI）进一步评估。肝胆期MRI显示肝胆造影剂钆贝葡胺出现非特异性均匀强化。由于该病变被解释为非典型病变，患者出院时被建议早期随访。出院6个月后的随访MRI显示有多处肝转移。结论 肝转移瘤通常在T1加权肝细胞期表现为肝胆造影剂强化。类癌瘤转移也可能表现出这种强化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/0436a955dd7a/amjcaserep-21-e924280-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/6bd682964d93/amjcaserep-21-e924280-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/7dd52c26a192/amjcaserep-21-e924280-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/f1cead5b6dd8/amjcaserep-21-e924280-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/142946da2600/amjcaserep-21-e924280-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/4150a2985ccd/amjcaserep-21-e924280-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/ce8194bcf98c/amjcaserep-21-e924280-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/28a32f35fd8b/amjcaserep-21-e924280-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/0436a955dd7a/amjcaserep-21-e924280-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/6bd682964d93/amjcaserep-21-e924280-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/7dd52c26a192/amjcaserep-21-e924280-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/f1cead5b6dd8/amjcaserep-21-e924280-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/142946da2600/amjcaserep-21-e924280-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/4150a2985ccd/amjcaserep-21-e924280-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/ce8194bcf98c/amjcaserep-21-e924280-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/28a32f35fd8b/amjcaserep-21-e924280-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/225e/7491956/0436a955dd7a/amjcaserep-21-e924280-g008.jpg

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本文引用的文献

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Liver MRI: From basic protocol to advanced techniques.肝脏磁共振成像：从基础协议到先进技术。
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The target sign in colorectal liver metastases: an atypical Gd-EOB-DTPA "uptake" on the hepatobiliary phase of MR imaging.结直肠癌肝转移中的靶征：磁共振成像肝胆期非典型钆塞酸二钠“摄取”
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肝内肿块型胆管癌：钆贝葡胺增强磁共振成像（Gd-BOPTA-MRI）的强化模式，重点关注肝胆期。
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