MRI to differentiate the nodular regenerative hyperplasia from hepatic metastases
10.3760/cma.j.cn113884-20241217-00381
- VernacularTitle:MRI鉴别肝结节再生性增生与肝转移瘤
- Author:
Zhengjun SUN
1
;
Rujia WANG
;
Mengsu ZENG
;
Mingliang WANG
Author Information
1. 复旦大学附属中山医院放射科，上海 200032
- Publication Type:Journal Article
- Keywords:
Colorectal cancer;
Magnetic resonance imaging;
Liver;
Nodular regenerative hyperplasia;
Metastases
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(10):750-753
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To differentiate the nodular regenerative hyperplasia (NRH) from colorectal liver metastases in patients during chemotherapy based on magnetic resonance imaging (MRI) scan.Methods:Clinical data of 58 patients with liver NRH ( n=18) or metastases ( n=40) during postoperative chemotherapy for colorectal cancer admitted to Zhongshan Hospital Affiliated to Fudan University from July 2014 to December 2021 were retrospectively analyzed, including 39 males and 19 females, aged (56.8±10.6) years. The morphology, margin, plain scan and enhanced features of the lesions were compared, and the apparent diffusion coefficient (ADC) values of the lesions and the surrounding normal liver parenchyma were measured. Results:A total of 45 lesions were found in 18 patients with liver NRH, and 111 lesions in 40 patients with liver metastases. The distribution of lesions between liver NRH and liver metastases showed a statistically significant difference ( χ2=71.22, P<0.001). The boundaries of lesions in liver NRH were clearer than those in liver metastases [82.2% (37/45) vs. 46.8% (52/111), χ2=11.43, P=0.016]. The ADC values of 45 liver NRH lesions were (1.54±0.60)×10 -3 mm 2/s, which were close to the ADC values of the surrounding normal liver tissue (1.57±0.63)×10 -3 mm 2/s ( t=0.59, P=0.167). The ADC values of 111 liver metastatic lesions were (1.09±0.04)×10 -3 mm 2/s, which were lower than those of the surrounding normal liver tissue (1.50±0.10)×10 -3 mm 2/s ( t=30.31, P<0.001). The ADC values of liver metastatic lesions were lower than those of the liver NRH lesions [(1.09±0.04)×10 -3 mm 2/s vs. (1.54±0.60)×10 -3 mm 2/s, t=10.82, P<0.001]. Dynamic contrast-enhanced MRI scans showed that the arterial phase of 45 liver NRH lesions was more significantly enhanced, and continued to be enhanced in the portal vein, late and delayed phases. Conclusion:NRH lesions that occur in patients undergoing chemotherapy for colorectal cancer have clear boundaries, unrestricted diffusion, obvious enhancement in the arterial phase, and continuous enhancement in the portal venous phase and delayed phase. The above MRI features are helpful in distinguishing NRH from metastatic tumors.
