MRI features to differentiate between peliosis hepatis and hepatic metastases following chemotherapy for gastrointestinal adenocarcinoma
10.3760/cma.j.issn.1007-8118.2019.09.006
- VernacularTitle: 胃肠道腺癌化疗过程出现的肝紫癜与肝转移瘤MRI特征比较
- Author:
Zhijian LIU
1
;
Tingting GENG
2
;
Mingliang WANG
3
,
4
,
5
;
Rongkui LUO
6
;
Guang DONG
1
;
Hai GENG
1
;
Mengsu ZENG
3
,
4
,
5
Author Information
1. Department of Radiology, Weifang People's Hospital, Weifang 261041, Shandong Province, China
2. Department of Intensive Care Unit, Weifang People's Hospital, Weifang 261041, Shandong Province, China
3. Department of Radiology, Zhongshan Hospital, Fudan University
4. Shanghai Institute of Medical Imaging
5. Department of Medical Imaging, Shanghai Medical College, Fudan University, Shanghai 200032, China
6. Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Colorectal neoplasms;
Magnetic resonance imaging;
Peliosis hepatis;
Hepatic metastases
- From:
Chinese Journal of Hepatobiliary Surgery
2019;25(9):660-663
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the MRI features of peliosis hepatis and hepatic metastases following chemotherapy for gastrointestinal adenocarcinoma with the aim to improve the differential diagnosis.
Methods:The clinical data of 33 patients with gastrointestinal adenocarcinoma treated from June 2014 to December 2017 at Zhongshan Hospital of Fudan University were retrospectively analyzed. Of the 26 males and 7 females aged (56.0±9.8) years, there were 11 patients with peliosis hepatis and 22 patients with hepatic metastases following chemotherapy in these patients. All patients underwent contrast-enhanced abdominal MRI scans. The differences in the MRI features, including morphology, margin, signal intensity on plain scanning and enhancement patterns were compared statistically. The apparent diffusion coefficient (ADC) values of peliosis hepatis, hepatic metastases and adjacent hepatic parenchyma were measured in an ADC map.
Results:In 14 lesions of the 11 patients with peliosis hepatis, 10 lesions were ill-defined and 4 lesions were well-defined. In 31 lesions of the 22 patients with hepatic metastases, 5 lesions were ill-defined and 26 lesions were well-defined. Significant differences existed between peliosis hepatis and hepatic metastases in the margin (P<0.05). The ADC value of hepatic metastases was significantly lower than that of peliosis hepatis and the adjacent hepatic parenchyma (P<0.05). In all the 14 lesions of peliosis hepatis, 10 lesions showed gradual filling enhancement, and 4 lesions showed marked and persistent enhancement. In all the 31 lesions of hepatic metastases, 28 lesions showed a ring-shaped enhancement, and 3 lesions showed "quick in and quick out" enhancement.
Conclusions:The lesions of peliosis hepatis following chemotherapy for gastrointestinal adenocarcinoma were ill-defined, with no restriction of water diffusion in the diffusion weighted imagings, and with progressive enhancement. The MRI manifestations of peliosis hepatis helped to differentiate peliosis hepatis from hepatic metastases of gastrointestinal adenocarcinoma.
