Diffusion/Perfusion MR Imaging of the Liver : Practice, Challenges, and Future
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概要
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Diffusion-weighted (DWI) magnetic resonance (MR) imaging is useful in diagnosing various pathologic conditions in the liver, such as malignant tumors or hepatic fibrosis, and is now part of routine MR imaging protocols for the liver following the development of a parallel encoding technique that has markedly improved image quality. DWI is not very sensitive for detecting hepatocellular carcinomas (HCC) and is useless for characterizing border-line hepatocellular nodules in cirrhosis, but it complements gadolinium-enhanced MR imaging in detecting regional tumor recurrence or intrahepatic metastases of HCC following treatment. DWI is more useful for detecting hepatic metastasis, because histopathologic architecture of metastases does not resemble that of liver tissue and T2 relaxation time of hepatic metasitasis is fairly longer than that of liver parenchyma. DWI is also useful for detecting moderate and advanced hepatic fibrosis. In cirrhosis, however, decreased blood flow in fibrotic liver is thought to lower apparent diffusion coefficient of the liver. For MR perfusion analysis, a dual-input one-compartment model is used to correlate various hepatic blood flow parameters that represent hepatic arterial/portal blood flow or fraction, mean transit time, and distribution volume with the severity of cirrhosis and portal hypertension. Conventional multisectional imaging and perfusion study can be combined using a 3-dimensional sequence with high temporal resolution, but spatial resolution is not sufficiently high to diagnose tiny hepatic lesions. The advent of liver-specific contrast agents, such as gadoxetic acid, may spur the development of a new analysis model that incorporates extracellular perfusion and hepatocyte function.
- 2012-09-01
著者
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Moriyama Noriyuki
Research Center For Cancer Prevention And Screening National Cancer Center
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GOSHIMA Satoshi
Department of Internal Medicine, Inami General Hospital
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Kawada Hiroshi
Department Of Cardiology Ashikaga Red Cross Hospital
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Watanabe Haruo
Department Of Bacteriology I National Institute Of Infectious Diseases
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Kondo Hiroshi
Department Of Agricultural Chemistry College Of Agriculture And Veterinary Medicine Nihon University
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Kanematsu Masayuki
Department Of Health Science Shiga University Of Medical Science
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MORIYAMA Noriyuki
Research Center for Cancer Prevention and Screening, National Cancer Center Hospital
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KANEMATSU Masayuki
Department of Radiology, Gifu University Hospital
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NODA Yoshifumi
Department of Radiology, Gifu University Hospital
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KAWADA Hiroshi
Department of Radiology, Gifu University Hospital
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KONDO Hiroshi
Department of Radiology, Gifu University Hospital
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WATANABE Haruo
Department of Radiology, Gifu University Hospital
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