Magnetic Resonance Imaging of Liver Metastasis

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• 作者：Ali Devrim Karaosmanoglu ; MD ; Mehmet Ruhi Onur ; MD ; Mustafa Nasuh Ozmen ; MD ; Deniz Akata ; MD ; Musturay Karcaaltincaba ; MD ; ^{musturayk@yahoo.com}
• 刊名：Seminars in Ultrasound, CT and MRI
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：37
• 期：6
• 页码：533-548
• 全文大小：4076 K
• 卷排序：37

文摘

Liver magnetic resonance imaging (MRI) is becoming the gold standard in liver metastasis detection and treatment response assessment. The most sensitive magnetic resonance sequences are diffusion-weighted images and hepatobiliary phase images after Gd-EOB-DTPA. Peripheral ring enhancement, diffusion restriction, and hypointensity on hepatobiliary phase images are hallmarks of liver metastases. In patients with normal ultrasonography, computed tomography (CT), and positron emission tomography (PET)-CT findings and high clinical suspicion of metastasis, MRI should be performed for diagnosis of unseen metastasis. In melanoma, colon cancer, and neuroendocrine tumor metastases, MRI allows confident diagnosis of treatment-related changes in liver and enables differential diagnosis from primary liver tumors. Focal nodular hyperplasia–like nodules in patients who received platinum-based chemotherapy, hypersteatosis, and focal fat can mimic metastasis. In cancer patients with fatty liver, MRI should be preferred to CT. Although the first-line imaging for metastases is CT, MRI can be used as a problem-solving method. MRI may be used as the first-line method in patients who would undergo curative surgery or metastatectomy. Current limitation of MRI is low sensitivity for metastasis smaller than 3 mm. MRI fingerprinting, glucoCEST MRI, and PET-MRI may allow simpler and more sensitive diagnosis of liver metastasis.