Objective To retrospectively assess the importance and imaging appearance of the signal intensity， the signal noise ratio (SNR), the contrast noise ratio (CNR) and enhancement patterns of early arterial phase in diagnosis and differential diagnosis of small hepatic nodular lesions on MRI. Methods Conventional spin-echo T2W, 2D GRE T1W plain scan and Gd-enhanced 3D-VIBE multi-phasic (early arterial, late arterial and portal venous phase) acquisitions were performed for 68 consecutive patients with 102 lesions on MRI. Native T2W and 2D GRE T1W were acquired first, then 3D-VIBE fast scanning at early arterial, late arterial and portal venous phase respectively. The SNR, CNR, signal intensity and enhanced pattern of the nodular lesions appearances on plain scan and eariy arterial phase were carefully observed. Results There were hyperintense in 102 (100%) lesions in T2W and hypointense in 95 (93.1%) lesions in T1W in plain scan. There were differences among the SNR, CNR of hepatic cyst, cavernous hemangioma, neoplasm metastasis and small hepatocellular carcinoma in T2W (P＜0.05)，the highest SNR and CNR of lesions were hepatic cyst. The SNR of small hepatocellular carcinoma and the CNR of hepatic cyst were highest in all the type diseases in T1W, there was significantly difference as compared with the other type diseases (P＜0.05). The enhancement rate of small hepatic nodular lesions was 76.5% in early arterial phase. The enhancement rate of small hepatocellular carcinoma and hepatic metastasis were 100% and 87.9% respectively. The non-enhancement rate of hepatic cyst were 100%. The common enhancement patterns of early arterial phase were peripheral enhancement which were 36 lesions (35.3%). The even enhancement and uneven enhancement were 22 lesions (21.6%) and 20 lesions (19.6%) respectively. Conclusion Qualitative and quantitative evaluation of MR signal intensity combined with the enhancement patterns of early arterial phase will help for qualitation and differential diagnosis of small hepatic nodular lesions on MRI.
【Abstract】ObjectiveTo investigate the diagnostic value of a fast gradient-echo (GRE) three-dimensional contrastenhanced volumetric interpolated breath-hold examination (3D-VIBE) MR sequence in evaluating focal liver lesions. MethodsConventional spin-echo T2W, 2D GRE T1W plain scan and Gd-enhanced 3D-VIBE multi-phasic（early arterial, late arterial and portal venous phases） acquisitions were prospectively performed for 51 consecutive patients suspected of having focal liver lesions on CT or ultrasound imaging. Native T2W and 2D GRE T1W were acquired first, then 3D-VIBE fast scanning at early arterial, late arterial and portal venous phases respectively. The SNR and CNR of the liver lesions on plain scan and the enhancement patterns on contrast-enhanced 3D-VIBE images were carefully observed with correlation of the clinical and surgical pathological findings. ResultsThere exited certain differences in SNR, CNR, and the enhancement patterns of different kinds of focal hepatic lesions in plain scan and Gd-enhanced multi-phasic 3D-VIBE acquisitions. Conclusion3D-VIBE MR sequence is helpful in the detection and characterization of focal liver lesions.
【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen. ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively. ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.
【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen. ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively. ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.
【Abstract】Objective To investigate the CT imaging features of metastatic hepatic adenocarcinomas from the digestive tract by using multidetectorrow helical CT (MDCT) with pathological correlation. Methods CT and clinical data of 36 patients with pathologically proven metastatic hepatic adenocarcinomas from the digestive tract were retrospectively reviewed. The primary tumors included 10 cases of gastric cancer, 1 duodenal cancer, 18 colonic carcinoma, 7 rectal cancer. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper or whole abdomen. The appearances of hepatic metastatic lesions on MDCT images at various enhancement phases were carefully observed. Results On plain CT scan 32 cases （88.9%） presented multiple nodules of low density at different sizes, 3 cases （8.3%） showed a single low-density nodule, and 1 case presented with a cystic mass. On contrast-enhanced scan, 4 cases (11.1%) showed faintly enhanced rim around the nodules on arterial phase; on portal venous phase 29 cases (80.6%) presented slight ringlike enhancement at the periphery of the nodule while the nodule core was markedly hypodense with intermediate soft tissue density area in between, giving rise to the typical appearance of “bull’seye” sign. Three cases (8.3%) showed no enhancement on either phase images. Conclusion The ring-like enhancement and the appearance of “bull’s-eye” on portal venous phase was characteristic CT features of metastatic hepatic adenocarcinoma from digestive tract.