CT and MR Imaging Evaluation of Diffuse Parenchymal Diseases of Liver_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Jinxiu , CHEN Guangwen , SONG Bin.

Department of Radiology, West China Hospital, Sichuan University， Chengdu 610041, China;

Corresponding author：

Keywords：

Diffuse hepatic parenchymal disease; Multi-detector row computed tomography; Magnetic resonance imaging

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Objective To introduce the current value of multi-detector row CT (MDCT) and magnetic resonance imaging (MRI) techniques on evaluation of diffuse hepatic parenchymal diseases.
Methods By literature review, the application and recent advances of various kinds of MDCT and MR imaging techniques in evaluating diffuse hepatic parenchymal diseases were summarized.
Results There were three kinds of diffuse liver parenchyma diseases, which were the diseases of storage, vascular and inflammatory. The morphology changes of diffuse liver parenchyma diseases could be demonstrated well by MDCT. MRI, especially MR functional imaging could reflect the morphology changes, and cellular metabolic activity of the liver, which provided qualitative and quantitative information for the diagnosis and evaluation of therapeutic effect on diffuse liver parenchyma diseases.
Conclusion MR imaging techniques, especially those functional techniques, developed rapidly and had practical value in both the diagnosis and severity assessment of hepatic fibrosis.

Citation： CHEN Jinxiu,CHEN Guangwen,SONG Bin.. CT and MR Imaging Evaluation of Diffuse Parenchymal Diseases of Liver. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(2): 195-199. doi: Copy

1.	Clark JM, Diehl AM. Nonalcoholic fatty liver disease: an underrecognized cause of cryptogenic cirrhosis [J]. JAMA， 2003; 289（22）: 30003004.
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3.	Bravo AA, Sheth SG, Chopra S. Liver biopsy [J]. N Engl J Med ， 2001; 344(7): 495500.
4.	Siegelman ES, Mitchell DG, Semelka RC. Abdominal iron deposition: metabolism, MR findings, and clinical importance [J]. Radiology， 1996; 199（1）: 1322.
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6.	Brissot P, Bourel M, Herry D, et al. Assessment of liver iron content in 271 patients: a reevaluation of direct and indirect methods [J]. Gastroenterology， 1981; 80(3): 557565.
7.	Abenoza P, Sibley RK. Farber’s disease: a fine structural study [J]. Ultrastruct Pathol， 1987; 11(4): 397403.
8.	Ros PR, Ji H. Special focus session: multisection (multidetector) CT: applications in the abdomen [J]. Radiographics， 2002; 22(3): 697700.
9.	Raptopoulos V, Karellas A, Bernstein J, et al. Value of dualenergy CT in differentiating focal fatty infiltration of the liver from lowdensity masses [J]. AJR Am J Roentgenol， 1991; 157(4): 721725.
10.	Hamer OW, Aguirre DA, Casola G, et al. Imaging features of perivascular fatty infiltration of the liver: initial observations [J]. Radiology， 2005; 237(1): 159169.
11.	Guyader D, Gandon Y, Deugnier Y, et al. Evaluation of computed tomography in the assessment of liver iron overload. A study of 46 cases of idiopathic hemochromatosis [J]. Gastroenterology， 1989; 97(3): 737743.
12.	Howard JM, Ghent CN, Carey LS, et al. Diagnostic efficacy of hepatic computed tomography in the detection of body iron overload [J]. Gastroenterology， 1983; 84(2): 209215.
13.	Levenson H, Greensite F, Hoefs J, et al. Fatty infiltration of the liver: quantification with phasecontrast MR imaging at 1.5 T vs biopsy [J]. AJR Am J Roentgenol， 1991; 156(2): 307312.
14.	KatzBrull R, Rofsky NM, Lenkinski RE. Breathhold abdominal and thoracic proton MR spectroscopy at 3 T [J]. Magn Reson Med， 2003; 50(3): 461467.
15.	Chmelík M, Schmid AI, Gruber S, et al. Threedimensional highresolution magnetic resonance spectroscopic imaging for absolute quantification of 31P metabolites in human liver [J]. Magn Reson Med， 2008; 60(4): 796802.
16.	Kim YK, Kim CS, Lee YH, et al. Comparison of superparamagnetic iron oxideenhanced and gadobenate dimeglumineenhanced dynamic MRI for detection of small hepatocellular carcinomas [J]. AJR Am J Roentgenol， 2004; 182(5): 12171223.
17.	王秋实, 郭启勇, 梁长虹，等. MR弥散加权成像评价肝纤维化的初步实验研究 [J]. 解剖学研究， 2007; 29(3): 212216.
18.	管生, 赵卫东, 周康荣，等. 磁共振弥散功能成像对肝脏早期弥漫性病变诊断价值的试验研究 [J]. 中华肝病杂志， 2005; 13（7）: 524527.
19.	Xu L, Gao PY. “Palpation by imaging”： magnetic resonance elastography [J]. Chin Med Sci J， 2006; 21(4): 281286.
20.	Cobbold JF, Morin S, TaylorRobinson SD. Transient elastography for the assessment of chronic liver disease: ready for the clinic? [J]. World J Gastroenterology， 2007; 13(36): 47914797.
21.	Garbow JR, Lin X, Sakata N, et al. In vivo MRS measurement of liver lipid levels in mice [J]. J Lipid Res, 2004; 45(7): 13641371.
22.	Thomas EL, Hamilton G, Patel N, et al. Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study [J]. Gut, 2005; 54(1): 122127.
23.	Szczepaniak LS, Nurenberg P, Leonard D, et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population [J]. Am J Physiol Endocrinol Metab, 2005; 288(2): E462 E468.
24.	Alústiza JM, Artetxe J, Castiella A, et al. MR quantification of hepatic iron concentration [J]. Radiology， 2004; 230(2): 479484.
25.	Westphalen AC, Qayyum A, Yeh BM, et al. Liver fat: effect of hepatic iron deposition on evaluation with opposedphase MR imaging [J]. Radiology， 2007; 242(2): 450455.
26.	Gandon Y, Olivié D, Guyader D, et al. Noninvasive assessment of hepatic iron stores by MRI [J]. Lancet， 2004; 363(9406): 357362.
27.	Andrews NC. Disorders of iron metabolism [J]. N Engl J Med， 1999; 341（26）: 19861995.
28.	Horton KM, Bluemke DA, Hruban RH, et al. CT and MR imaging of benign hepatic and biliary tumors [J]. Radiographics， 1999; 19（2）: 431451.
29.	Lorigan JG, Charnsangavej C, Carrasco CH, et al. Atrophy with compensatory hypertrophy of the liver in hepatic neoplasms: radiographic findings [J]. AJR Am J Roentgenol， 1988; 150（6）: 12911295.
30.	Mathieu D, Vasile N, Menu Y, et al. BuddChiari syndrome: dynamic CT [J]. Radiology， 1987; 165（2）: 409413.
31.	Kawamoto S, Soyer PA, Fishman EK, et al. Nonneoplastic liver disease: evaluation with CT and MR imaging [J]. Radiographics， 1998; 18（4）: 827848.
32.	Proujansky R, Vinton N. Acute hepatitis [J]. Adolesc Med， 1995; 6（3）: 437446.
33.	Semelka RC, Kelekis NL, Sallah S, et al. Hepatosplenic fungal disease: diagnostic accuracy and spectrum of appearances on MR imaging [J]. AJR Am J Roentgenol， 1997; 169（5）: 13111316.
34.	Sallah S, Semelka RC, Wehbie R, et al. Hepatosplenic candidiasis in patients with acute leukaemia [J]. Br J Haematol， 1999; 106（3）: 697701.
35.	Thanos L, Zormpala A, Brountzos E, et al. Nodular hepatic and splenic sarcoidosis in a patient with normal chest radiograph [J]. Eur J Radiol， 2002; 41（1）: 1011.
36.	Sakai T, Maeda M, Takabatake M, et al. MR imaging of hepatosplenic sarcoidosis [J]. Radiat Med， 1995; 13（1）: 3941.

1. Clark JM, Diehl AM. Nonalcoholic fatty liver disease: an underrecognized cause of cryptogenic cirrhosis [J]. JAMA， 2003; 289（22）: 30003004.
2. Brunt EM. Nonalcoholic steatohepatitis: definition and pathology [J]. Semin Liver Dis， 2001; 21（1）: 316.
3. Bravo AA, Sheth SG, Chopra S. Liver biopsy [J]. N Engl J Med ， 2001; 344(7): 495500.
4. Siegelman ES, Mitchell DG, Semelka RC. Abdominal iron deposition: metabolism, MR findings, and clinical importance [J]. Radiology， 1996; 199（1）: 1322.
5. Adams P, Brissot P, Powell LW. EASL International Consensus Conference on Haemochromatosis [J]. J Hepatol， 2000; 33(3): 485504.
6. Brissot P, Bourel M, Herry D, et al. Assessment of liver iron content in 271 patients: a reevaluation of direct and indirect methods [J]. Gastroenterology， 1981; 80(3): 557565.
7. Abenoza P, Sibley RK. Farber’s disease: a fine structural study [J]. Ultrastruct Pathol， 1987; 11(4): 397403.
8. Ros PR, Ji H. Special focus session: multisection (multidetector) CT: applications in the abdomen [J]. Radiographics， 2002; 22(3): 697700.
9. Raptopoulos V, Karellas A, Bernstein J, et al. Value of dualenergy CT in differentiating focal fatty infiltration of the liver from lowdensity masses [J]. AJR Am J Roentgenol， 1991; 157(4): 721725.
10. Hamer OW, Aguirre DA, Casola G, et al. Imaging features of perivascular fatty infiltration of the liver: initial observations [J]. Radiology， 2005; 237(1): 159169.
11. Guyader D, Gandon Y, Deugnier Y, et al. Evaluation of computed tomography in the assessment of liver iron overload. A study of 46 cases of idiopathic hemochromatosis [J]. Gastroenterology， 1989; 97(3): 737743.
12. Howard JM, Ghent CN, Carey LS, et al. Diagnostic efficacy of hepatic computed tomography in the detection of body iron overload [J]. Gastroenterology， 1983; 84(2): 209215.
13. Levenson H, Greensite F, Hoefs J, et al. Fatty infiltration of the liver: quantification with phasecontrast MR imaging at 1.5 T vs biopsy [J]. AJR Am J Roentgenol， 1991; 156(2): 307312.
14. KatzBrull R, Rofsky NM, Lenkinski RE. Breathhold abdominal and thoracic proton MR spectroscopy at 3 T [J]. Magn Reson Med， 2003; 50(3): 461467.
15. Chmelík M, Schmid AI, Gruber S, et al. Threedimensional highresolution magnetic resonance spectroscopic imaging for absolute quantification of 31P metabolites in human liver [J]. Magn Reson Med， 2008; 60(4): 796802.
16. Kim YK, Kim CS, Lee YH, et al. Comparison of superparamagnetic iron oxideenhanced and gadobenate dimeglumineenhanced dynamic MRI for detection of small hepatocellular carcinomas [J]. AJR Am J Roentgenol， 2004; 182(5): 12171223.
17. 王秋实, 郭启勇, 梁长虹，等. MR弥散加权成像评价肝纤维化的初步实验研究 [J]. 解剖学研究， 2007; 29(3): 212216.
18. 管生, 赵卫东, 周康荣，等. 磁共振弥散功能成像对肝脏早期弥漫性病变诊断价值的试验研究 [J]. 中华肝病杂志， 2005; 13（7）: 524527.
19. Xu L, Gao PY. “Palpation by imaging”： magnetic resonance elastography [J]. Chin Med Sci J， 2006; 21(4): 281286.
20. Cobbold JF, Morin S, TaylorRobinson SD. Transient elastography for the assessment of chronic liver disease: ready for the clinic? [J]. World J Gastroenterology， 2007; 13(36): 47914797.
21. Garbow JR, Lin X, Sakata N, et al. In vivo MRS measurement of liver lipid levels in mice [J]. J Lipid Res, 2004; 45(7): 13641371.
22. Thomas EL, Hamilton G, Patel N, et al. Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study [J]. Gut, 2005; 54(1): 122127.
23. Szczepaniak LS, Nurenberg P, Leonard D, et al. Magnetic resonance spectroscopy to measure hepatic triglyceride content: prevalence of hepatic steatosis in the general population [J]. Am J Physiol Endocrinol Metab, 2005; 288(2): E462 E468.
24. Alústiza JM, Artetxe J, Castiella A, et al. MR quantification of hepatic iron concentration [J]. Radiology， 2004; 230(2): 479484.
25. Westphalen AC, Qayyum A, Yeh BM, et al. Liver fat: effect of hepatic iron deposition on evaluation with opposedphase MR imaging [J]. Radiology， 2007; 242(2): 450455.
26. Gandon Y, Olivié D, Guyader D, et al. Noninvasive assessment of hepatic iron stores by MRI [J]. Lancet， 2004; 363(9406): 357362.
27. Andrews NC. Disorders of iron metabolism [J]. N Engl J Med， 1999; 341（26）: 19861995.
28. Horton KM, Bluemke DA, Hruban RH, et al. CT and MR imaging of benign hepatic and biliary tumors [J]. Radiographics， 1999; 19（2）: 431451.
29. Lorigan JG, Charnsangavej C, Carrasco CH, et al. Atrophy with compensatory hypertrophy of the liver in hepatic neoplasms: radiographic findings [J]. AJR Am J Roentgenol， 1988; 150（6）: 12911295.
30. Mathieu D, Vasile N, Menu Y, et al. BuddChiari syndrome: dynamic CT [J]. Radiology， 1987; 165（2）: 409413.
31. Kawamoto S, Soyer PA, Fishman EK, et al. Nonneoplastic liver disease: evaluation with CT and MR imaging [J]. Radiographics， 1998; 18（4）: 827848.
32. Proujansky R, Vinton N. Acute hepatitis [J]. Adolesc Med， 1995; 6（3）: 437446.
33. Semelka RC, Kelekis NL, Sallah S, et al. Hepatosplenic fungal disease: diagnostic accuracy and spectrum of appearances on MR imaging [J]. AJR Am J Roentgenol， 1997; 169（5）: 13111316.
34. Sallah S, Semelka RC, Wehbie R, et al. Hepatosplenic candidiasis in patients with acute leukaemia [J]. Br J Haematol， 1999; 106（3）: 697701.
35. Thanos L, Zormpala A, Brountzos E, et al. Nodular hepatic and splenic sarcoidosis in a patient with normal chest radiograph [J]. Eur J Radiol， 2002; 41（1）: 1011.
36. Sakai T, Maeda M, Takabatake M, et al. MR imaging of hepatosplenic sarcoidosis [J]. Radiat Med， 1995; 13（1）: 3941.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

CT and MR Imaging Evaluation of Diffuse Parenchymal Diseases of Liver

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