三维适形放疗后放射性肝损伤的MRI表现  

Magnetic resonance imaging findings of liver injury induced by three-dimensional conformal radiotherapy

作　　者：陈大朝[1] 陈龙华[1] 金吴东[1] 许乙凯[2] 许鹏君[2] 

机构地区：[1]南方医科大学南方医院放疗科,广东广州510515 [2]南方医科大学南方医院影像中心,广东广州510515

出　　处：《南方医科大学学报》2007年第2期181-183,187,共4页Journal of Southern Medical University

摘　　要：目的分析放射性肝损伤的MRI表现。方法回顾性分析2001年9月至2005年10月我科的20例放射性肝损伤的MRI资料,20例患者均因肝脏肿瘤接受过1￣2疗程的三维适形放疗,MRI资料包括平扫与增强扫描,4例因疑肿瘤复发而经穿刺确诊为放射性肝损伤。结果急性放射性肝损伤表现为与受照射区形态相似大片状肝水肿,T1WI上为低信号,T2WI为高信号,Gd-DTPA增强后动脉期无强化。慢性放射性肝损伤平扫T1WI为不规则片状稍低信号,T2WI为稍高信号,Gd-DTPA增强后动脉期强化不明显,静脉期及延迟期强化明显。结论放射性肝损伤MRI表现有一定的特征性;MRI平扫与动态增强扫描有较高的诊断价值。Objective To analyze the magnetic resonance imaging （MRI） findings of radiation-induced liver injury following three-dimensional conformal radiotherapy. Methods A retrospective review of the MRI data was conducted in 20 patients treated between September 2000 and October 2005, who suffered liver injuries induced by 1 or 2 three-dimensional conformal radiotherapy sessions for liver neoplasm. The patients underwent MR scans with T2-weighted sequences and T1-weighted sequences in both plain and Gd-DTPA enhanced MRI. Four patients with suspected tumor relapse suggested by MRI were pathologically confirmed to have radiation-induced liver injury. Results Acute radiation-induced liver injury was represented by large patches of liver edema consistent with the irradiation volume, showing low signal intensity on T1-weighted images （T1WI） and high signal intensity on T2-weighted images （T2WI） without arterial phase enhancement after Gd-DTPA injection. Delayed radiation-induced liver injury was manifested by slightly low-intensity signal on plain TIWI and slightly high-intensity signal on T2WI without obvious arterial phase enhancement following Gd-DTPA injection but with marked enhancement during the portal-venous and delayed phases. Conclusion Radiation-induced liver injury presents characteristic MRI features, and plain and dynamic enhanced MRI can be of great value for its diagnosis.

关 键 词：三维适形放疗 放射性肝损伤 磁共振成像 

分 类 号：R818.7[医药卫生—放射医学] R445.2[医药卫生—临床医学]