Yamada Kazuki, Fujita Yasuhiko, Amagai Teruyoshi
Department of Medicine, Tokunoshima Tokushukai General Hospital, Kagoshima, Japan.
Faculty of Health Care Sciences, Department of Clinical Engineering, Jikei University of Health Care Sciences, 1-2-8, Miyahara, Yodogawa-Ku, Osaka, 532-0003, Japan.
Radiol Case Rep. 2022 May 5;17(7):2583-2588. doi: 10.1016/j.radcr.2022.03.101. eCollection 2022 Jul.
A 72-year-old female diagnosed with rectal cancer treated with a surgical procedure was reported. As 3 liver metastases (LMs) appeared in multidetector CT, adjuvant chemotherapy using Bevacizumab combined with modified FOLFOX-6 was completed. LMs were changed to cystic lesions during the follow-up period, consistent with liquefactive necrosis. These cystic lesions that appeared in the course of disappearing LMs (DLMs) were identified by CT as homogeneous low signal intensity in hepatocyte specific Gd-enhanced MRI. This might be pathognomonic radiological footprint equivalent to liquefactive necrosis observed in the process of DLM and must be carefully followed in the course of radiological complete response. The radiological changing findings of LMs to cystic changes, high sensitivity of detecting DLM, and limitations of Gd-MRI might be meaningful to clinicians.
报告了一名72岁经手术治疗的直肠癌女性患者。由于在多排螺旋CT上出现了3处肝转移灶（LM），遂完成了使用贝伐单抗联合改良FOLFOX-6的辅助化疗。在随访期间，肝转移灶转变为囊性病变，符合液化性坏死。这些在肝转移灶消失过程中出现的囊性病变（DLM）在CT上表现为肝细胞特异性钆增强磁共振成像中的均匀低信号强度。这可能是与在肝转移灶消失过程中观察到的液化性坏死等效的特征性影像学表现，在影像学完全缓解过程中必须密切随访。肝转移灶向囊性改变的影像学变化、检测肝转移灶消失的高敏感性以及钆增强磁共振成像的局限性可能对临床医生具有重要意义。
