Magnetic resonance imaging characteristics of primary diffuse large B-cell lymphoma of the liver / 中华肝胆外科杂志

ABSTRACT

Objective:To study the magnetic resonance imaging (MRI) features of primary hepatic diffuse large B-cell lymphoma (PDLBCLL) with the aim to improve the diagnosis of this disease.Methods:The clinical data of 15 patients with PDLBCLL confirmed by biopsy or surgical resection specimens at Zhongshan Hospital of Fudan University and Yiwu Central Hospital from May 2015 to August 2021 were retrospectively analyzed. There were 8 males and 7 females, aged (58.3±12.0) years old. Thirteen patients underwent conventional Gd-DTPA enhanced MR examinations, and 2 patients underwent hepatobiliary specific contrast agent (Gd-EOB-DTPA) enhanced MR examinations. Image analysis included the number, location, size, shape, signal intensity and enhancement features of the lesions. Apparent diffusion coefficient (ADC) values of lesions and surrounding liver parenchyma were measured on the ADC map, and paired sample t-test was used to compare the differences between the two groups. Results:In 15 patients, 10 patients had a single, 4 had multiple lesions. In 1 patient, there was diffuse, mild enhancement in the arterial phase, slow decrease in the early portal venous, late portal venous and equilibrium phases, and ring low signal signals were detected in the hepatobiliary specific phase. The average ADC value of the 15 patients was (0.826±0.379)×10 -3 mm 2/s, and the average ADC value of the adjacent liver parenchyma was (1.311±0.236)×10 -3 mm 2/s. The difference was significant ( P<0.05). Uniform signals were detected in lesions in 3 patients, in the scar tissues of 2 patients, moderate enhancement scan lesions were improved in 10 patients, mild aggrandizement in 5 patients, lesions showing a " floating vessels" sign in 6 patients, lesions showing a typical " target" appearance in 7 patients, abnormal perfusion around the lesion in 7 patients, and compression of bile ducts with perifocal bile duct dilatation in 2 patients. Conclusion:The MRI findings of PDLBCLL showed certain characteristics. The lesion boundary was clear and the signal was uneven. Contrast-enhanced scans showed a lack of blood supply, most of which were accompanied by necrosis, and the " vessel floating sign" and " target sign" were characteristic.