Department of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy.
University Hospital of Padova, Institute of Radiology, Padova 35128, Italy.
World J Gastroenterol. 2023 Sep 28;29(36):5180-5197. doi: 10.3748/wjg.v29.i36.5180.
The liver is one of the organs most commonly involved in metastatic disease, especially due to its unique vascularization. It's well known that liver metastases represent the most common hepatic malignant tumors. From a practical point of view, it's of utmost importance to evaluate the presence of liver metastases when staging oncologic patients, to select the best treatment possible, and finally to predict the overall prognosis. In the past few years, imaging techniques have gained a central role in identifying liver metastases, thanks to ultrasonography, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). All these techniques, especially CT and MRI, can be considered the non-invasive reference standard techniques for the assessment of liver involvement by metastases. On the other hand, the liver can be affected by different focal lesions, sometimes benign, and sometimes malignant. On these bases, radiologists should face the differential diagnosis between benign and secondary lesions to correctly allocate patients to the best management. Considering the above-mentioned principles, it's extremely important to underline and refresh the broad spectrum of liver metastases features that can occur in everyday clinical practice. This review aims to summarize the most common imaging features of liver metastases, with a special focus on typical and atypical appearance, by using MRI.
肝脏是转移性疾病最常累及的器官之一,特别是由于其独特的血管化。众所周知,肝转移是最常见的肝脏恶性肿瘤。从实际的角度来看,在对肿瘤患者进行分期时,评估肝转移的存在,选择最佳的治疗方法,最终预测整体预后,这一点至关重要。在过去的几年中,由于超声、增强计算机断层扫描(CT)和磁共振成像(MRI)的应用,影像学技术在识别肝转移方面发挥了核心作用。所有这些技术,特别是 CT 和 MRI,可以被认为是评估转移灶累及肝脏的非侵入性参考标准技术。另一方面,肝脏可能会受到不同的局灶性病变的影响,有时是良性的,有时是恶性的。在此基础上,放射科医生应面对良性和继发性病变之间的鉴别诊断,以便正确地为患者分配最佳的治疗方案。基于上述原则,非常有必要强调并更新在日常临床实践中可能出现的广泛的肝转移特征。本文旨在总结肝脏转移的最常见的影像学特征,重点介绍 MRI 中的典型和非典型表现。