"Speckled Enhancement" on Gd-EOB-DTPA Enhanced MR Imaging of Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma.

IF 2.5 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Magnetic Resonance in Medical Sciences Pub Date : 2023-07-01 DOI:10.2463/mrms.mp.2021-0069

Ryota Hyodo, Yasuo Takehara, Ayumi Nishida, Masaya Matsushima, Shinji Naganawa

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引用次数: 2

Abstract

Purpose: To elucidate MRI features of primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma, particularly, the "speckled enhancement" on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI.

Methods: The institutional review board approved this retrospective observational study and waived informed consent. Using our picture archiving and communication systems and electronic medical records, five patients histopathologically diagnosed as hepatic MALT lymphoma and clinically confirmed as primary lesions who had undergone dynamic contrast-enhanced (DCE)-CT and DCE-MRI with Gd-EOB-DTPA were identified from September 2009 to December 2020. Two radiologists assessed their CT and MRI data in consensus with a pathologist's advice.

Results: Overall, five lesions in five patients were included in this study. Precontrast CT showed hypoattenuation in all lesions. In the arterial phase of DCE-CT, four lesions (80%) showed hyperattenuation, whereas all lesions showed iso- to hypoattenuation in the delayed phase. A vessel penetration sign was also observed in all lesions. On MRI, all lesions showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and restricted diffusion on diffusion-weighted images. Both DCE-CT and DCE-MRI with Gd-EOB-DTPA showed similar enhancement patterns, except for the hepatocyte phase. Notably, however, four out of five lesions showed characteristic "speckled enhancement" that refers to punctate positive enhancements within the low signal lesions on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI pathologically confirmed to be hepatocyte clusters that remained in the tumor.

Conclusion: Primary hepatic MALT lymphomas were characterized by arterial phase enhancement, restricted diffusion, vessel penetration sign, and more specifically "speckled enhancement" in the hepatobiliary phase of DCE-MRI with Gd-EOB-DTPA.

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Gd-EOB-DTPA增强原发性肝黏膜相关淋巴组织淋巴瘤MR成像的“斑点强化”。

目的:探讨原发性肝黏膜相关淋巴组织(MALT)淋巴瘤的MRI表现，特别是钆乙氧基苄基二乙烯三胺五乙酸(Gd-EOB-DTPA)增强MRI的“斑点强化”。方法:机构审查委员会批准了这项回顾性观察性研究并放弃知情同意。利用我院图片存档、通讯系统及电子病历，于2009年9月至2020年12月对5例经组织病理学诊断为肝脏MALT淋巴瘤，临床证实为原发病变的患者进行Gd-EOB-DTPA动态对比增强(DCE)-CT和DCE- mri检查。两名放射科医生根据病理学家的建议评估了他们的CT和MRI数据。结果:总体而言，5例患者的5个病变被纳入本研究。造影前CT均显示病灶低衰减。在DCE-CT动脉期，4个病变(80%)表现为高衰减，而所有病变在延迟期均表现为等至低衰减。所有病变均可见血管渗透征象。MRI上所有病变均表现为t1加权低信号，t2加权高信号，弥散加权扩散受限。除肝细胞期外，Gd-EOB-DTPA的DCE-CT和DCE-MRI均显示相似的增强模式。然而，值得注意的是，5个病变中有4个表现出特征性的“斑点强化”，这是指gd - eob - dtpa增强MRI在肝胆期低信号病变内的点状阳性强化，病理证实为保留在肿瘤中的肝细胞簇。结论:原发性肝脏MALT淋巴瘤在DCE-MRI Gd-EOB-DTPA检查中表现为动脉期强化、弥散受限、血管穿透征象，更具体的表现为肝胆期“斑状强化”。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Magnetic Resonance in Medical Sciences RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

5.80

自引率

20.00%

发文量

审稿时长

>12 weeks

期刊介绍： Magnetic Resonance in Medical Sciences (MRMS or Magn Reson Med Sci) is an international journal pursuing the publication of original articles contributing to the progress of magnetic resonance in the field of biomedical sciences including technical developments and clinical applications. MRMS is an official journal of the Japanese Society for Magnetic Resonance in Medicine (JSMRM).