钆塞酸二钠增强MRI上的结直肠癌肝转移：化疗后典型特征减少。
Colorectal liver metastases on gadoxetic acid-enhanced MRI: Typical characteristics decrease after chemotherapy.
作者信息
van der Reijd Denise J, Soykan Ezgi A, Heeres Birthe C, Lambregts Doenja M J, Vollebergh Marieke A, Kuhlmann Koert F D, Kok Niels F M, Snaebjornsson Petur, Beets-Tan Regina G H, Maas Monique, Klompenhouwer Elisabeth G
机构信息
Department of Radiology, Antoni van Leeuwenhoek - The Netherlands Cancer Institute, Amsterdam, the Netherlands; GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
Department of Radiology, Antoni van Leeuwenhoek - The Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
出版信息
Clin Imaging. 2025 Mar;119:110417. doi: 10.1016/j.clinimag.2025.110417. Epub 2025 Jan 27.
PURPOSE
To determine to what extent colorectal liver metastases (CRLM) display typical imaging characteristics on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and what changes after chemotherapy.
METHODS
We retrospectively identified 258 patients with a gadoxetic acid-enhanced MRI between 2015 and 2021 and pathologically proven non-mucinous adenocarcinoma CRLM. 722 unique CRLMs were analyzed: 378 CRLM in only the chemotherapy-naïve analysis; 217 in post-chemotherapy analysis; and 127 CRLM were analyzed both pre- and post-chemotherapy. The following six characteristics were defined as typical; "hypovascular", "unenhanced T1-weighted (UE-T1W) hypointensity", "arterial rim enhancement", "non-enhancing during hepatobiliary phase", "T2-weighted (T2W) mild hyperintensity", and "diffusion restriction".
RESULTS
All six typical characteristics were found in 249/505 chemotherapy-naïve CRLM (49 %) and 87/344 post-chemotherapy CRLM (25 %). The occurrence of some typical characteristics decreased post-chemotherapy: UE-T1W hypointensity 485/505 (96 %) versus 311/336 (93 %), arterial rim enhancement 291/498 (58 %) versus 154/301 (51 %), T2W mild hyperintensity 478/505 (95 %) versus 269/338 (79 %), and diffusion restriction 435/497 (87 %) versus 200/306 (65 %). Almost all metastases showed a hypovascular appearance, both in the chemotherapy-naïve (495/504, 98 %) and post-chemotherapy group (330/331, 100 %). Additionally, all CRLM appeared non-enhancing compared to the liver in the hepatobiliary phase (100 %).
CONCLUSION
Most CRLM show various combinations of at least five typical characteristics on gadoxetic acid-enhanced MRI. Arterial rim enhancement is the least prevalent characteristic both in chemotherapy-naïve and post-chemotherapy patients. Post-chemotherapy the occurrence of typical MRI characteristics decreases, especially mild T2W hyperintensity and the presence of diffusion restriction.
目的
确定结直肠癌肝转移（CRLM）在钆塞酸增强磁共振成像（MRI）上显示典型影像特征的程度以及化疗后的变化。
方法
我们回顾性纳入了2015年至2021年间接受钆塞酸增强MRI检查且经病理证实为非黏液腺癌CRLM的258例患者。共分析了722个独立的CRLM：单纯未接受过化疗分析中的378个CRLM；化疗后分析中的217个；以及127个在化疗前后均进行分析的CRLM。以下六个特征被定义为典型特征：“乏血供”、“T1加权像非强化低信号（UE-T1W低信号）”、“动脉期边缘强化”、“肝胆期无强化”、“T2加权像（T2W）轻度高信号”和“扩散受限”。
结果
在505个未接受过化疗的CRLM中，249个（49%）具备所有六个典型特征；在344个化疗后的CRLM中，87个（25%）具备所有六个典型特征。化疗后部分典型特征的出现率下降：UE-T1W低信号，未化疗组为485/505（96%），化疗后组为311/336（93%）；动脉期边缘强化，未化疗组为291/498（58%），化疗后组为154/301（51%）；T2W轻度高信号，未化疗组为478/505（95%），化疗后组为269/338（79%）；扩散受限，未化疗组为435/497（87%），化疗后组为200/306（65%）。几乎所有转移灶在未接受过化疗组（495/504，98%）和化疗后组（330/331，100%）均表现为乏血供。此外，所有CRLM在肝胆期与肝脏相比均无强化（100%）。
结论
大多数CRLM在钆塞酸增强MRI上显示至少五个典型特征的各种组合。动脉期边缘强化在未接受过化疗和化疗后的患者中都是最不常见的特征。化疗后典型MRI特征的出现率下降，尤其是T2W轻度高信号和扩散受限的存在。
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