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一例经治疗的腹部淋巴瘤患者发生放射性肝病的罕见病例,表现为高[F]FDG摄取及与照射剂量成比例的低EOB摄取。

A Rare Case of Radiation-Induced Liver Disease in Treated Abdominal Lymphoma Showing High [F]FDG Avidity and Low EOB Uptake Proportional to the Irradiation Dose.

作者信息

Usami Aya, Yokoyama Kota, Tsuchiya Junichi, Umezawa Yoshihiro, Toda Kazuma, Tateishi Ukihide, Yoshimura Ryoichi

机构信息

Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.

Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.

出版信息

Diagnostics (Basel). 2022 Feb 16;12(2):504. doi: 10.3390/diagnostics12020504.

Abstract

A 44-year-old woman presented with high [F]FDG uptake liver lesion after six courses of R-CHOP and radiotherapy for abdominal DLBCL, which was misdiagnosed as a hepatic invasion. EOB-MRI showed slight T2 hyperintensity, low-intensity DWI, and decreased EOB uptake in the hepatocellular phase. Compared with the pretreatment planning CT, the liver lesion coincided with the area of >40.5 Gy, resulting in the diagnosis of RILD. At the follow-up [F]FDG PET/CT 7 months after irradiation, the abnormal liver uptake disappeared. Comparing [F]FDG PET/CT, EOB-MRI, and planning CT can lead to the correct diagnosis of RILD and avoid unnecessary biopsies and treatment changes.

摘要

一名44岁女性在接受6个疗程的R-CHOP方案化疗及腹部弥漫性大B细胞淋巴瘤放疗后,出现肝脏[F]FDG摄取增高灶,最初被误诊为肝侵犯。EOB-MRI显示T2加权像轻度高信号、扩散加权成像(DWI)低信号以及肝细胞期EOB摄取减低。与放疗前计划CT相比,肝脏病灶与接受超过40.5 Gy照射的区域相符,最终诊断为放射性肝损伤(RILD)。在放疗后7个月的随访[F]FDG PET/CT检查中,肝脏异常摄取消失。对比[F]FDG PET/CT、EOB-MRI及计划CT有助于RILD的正确诊断,避免不必要的活检及治疗方案更改。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46ca/8870758/09a8b9fffc4d/diagnostics-12-00504-g001.jpg

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