[Magnetic resonance imaging findings of liver injury induced by three-dimensional conformal radiotherapy].
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 T1WI 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.


CONCLUSIONS
Radiation-induced liver injury presents characteristic MRI features, and plain and dynamic enhanced MRI can be of great value for its diagnosis.
Chen
Da-Chao
DC
Department of Radiotherapy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. chendachaox@sohu.com
Chen
Long-Hua
LH
Jin
Wu-Dong
WD
Xu
Yi-Kai
YK
Xu
Peng-Jun
PJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000209:etiology; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis* / Q000473:pathology; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000379:methods; D012680:Sensitivity and Specificity