Kelekis N L, Semelka R C, Siegelman E S, Ascher S M, Outwater E K, Woosley J T, Reinhold C, Mitchell D G
Department of Radiology, University of North Carolina at Chapel Hill 27599-7510, USA.
Magn Reson Imaging. 1997;15(6):625-36. doi: 10.1016/s0730-725x(97)00111-2.
This study demonstrates the appearance of focal hepatic lymphoma using current magnetic resonance techniques including gadolinium enhancement. Fifteen patients with hepatic lymphoma were imaged at 1.5T. T1-weighted, T2-weighted, immediate, and 5-10-min delayed T1-weighted spoiled gradient echo images were acquired in all patients. Determination was made of lesion size, number, morphology, and signal intensity of lesions on all sequences. Seven patients had solitary lesions and 8 patients had multiple lesions. Focal lesions of hepatic lymphoma ranged in size from 5 mm to 15 cm. They were well defined masses with mild to moderate low signal intensity relative to liver on T1-weighted images. Lymphoma lesions in 6 patients were moderately high in signal intensity on T2-weighted images compared with liver (Type I lesions), and enhancement of lesions was intense on early post-gadolinium images in 5 of these patients. Lymphoma lesions in 6 patients were mildly hypointense to mildly hyperintense on T2-weighted images compared to liver (Type II lesions), and lesions in 5 of these patients enhanced minimally on the early post-gadolinium spoiled gradient echo images. The remaining 3 patients had received chemotherapy before the magnetic resonance examination, and the imaging findings varied reflecting presumed differences in treatment responses. Transient ill defined perilesional enhancement on immediate post-gadolinium spoiled gradient echo images was observed in 9 patients including patients with either type of lesion. Focal lesions of hepatic lymphoma are usually low in signal intensity on T1-weighted images but have variable signal intensity on T2-weighted images. In general, lesions that are mildly hypointense to minimally hyperintense in signal intensity on T2-weighted images enhance minimally, and lesions moderately high in signal intensity of T2-weighted images enhance intensely. Transient increased perilesional enhancement is common.
本研究利用包括钆增强在内的当前磁共振技术展示了局灶性肝淋巴瘤的表现。15例肝淋巴瘤患者在1.5T磁场下进行成像。所有患者均采集了T1加权、T2加权、即刻及5 - 10分钟延迟T1加权扰相梯度回波图像。确定了所有序列上病变的大小、数量、形态及信号强度。7例患者有单个病变，8例患者有多个病变。肝淋巴瘤的局灶性病变大小从5毫米至15厘米不等。它们是边界清晰的肿块，在T1加权图像上相对于肝脏呈轻度至中度低信号强度。6例患者的淋巴瘤病变在T2加权图像上相对于肝脏呈中度高信号强度（I型病变），其中5例患者的病变在钆剂注射后早期图像上强化明显。6例患者的淋巴瘤病变在T2加权图像上相对于肝脏呈轻度低信号至轻度高信号（II型病变），其中5例患者的病变在钆剂注射后早期扰相梯度回波图像上强化轻微。其余3例患者在磁共振检查前接受过化疗，成像表现各异，反映出推测的治疗反应差异。9例患者（包括两种类型病变的患者）在钆剂注射后即刻扰相梯度回波图像上观察到短暂的、边界不清的病灶周围强化。肝淋巴瘤的局灶性病变在T1加权图像上通常信号强度较低，但在T2加权图像上信号强度可变。一般来说，T2加权图像上信号强度呈轻度低信号至轻度高信号的病变强化轻微，T2加权图像上信号强度呈中度高信号的病变强化明显。短暂的病灶周围强化增加很常见。
