Liver Sarcoidosis with Unique MRI Images Using Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid.
Sarcoidosis is a systemic disease characterized by the formation of non-caseating granulomas in multiple organs. In the diagnosis of sarcoidosis, imaging modalities such as ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) are useful;however, there are few reports of MRI imaging using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB) MRI. A 46-year-old Japanese female with suspected pulmonary sarcoidosis was admitted to our hospital because low-density mottles in the liver were observed incidentally by chest CT. The low-density mottles were not enhanced at the arterial phase or portal phase by abdominal CT and MRI, and decreased uptake was observed in the hepatobiliary phase of Gd-EOB MRI. No hematological disorder was observed except for a slight increase of biliary enzymes. The lesion was diagnosed as liver sarcoidosis by the liver biopsy. Since the patient refused steroid therapy, we prescribed ursodeoxycholic acid (UDCA). 600mg/day. The serum levels of biliary enzymes were normalized and the abdominal CT findings gradually improved after the initiation of UDCA medication. Gd-EOB MRI showed unique hypointense areas in the liver at the hepatobiliary phase, which might be useful in the diagnosis of liver sarcoidosis.
Liver Disease Center, Okayama Citizen's Hospital, Okayama 700-0833, Japan.wada-08-ben-08@cotton.ocn.ne.jp.
Nozomu
N
Wada
Kazuhiro
K
Nouso
Kazuya
K
Kariyama
Akiko
A
Wakuta
Masayuki
M
Kishida
Mamoru
M
Nishimura
Toshihiro
T
Higashi
D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008107:Liver Diseases / Q000188:drug therapy / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D012507:Sarcoidosis / Q000188:drug therapy / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
C073590:gadolinium ethoxybenzyl DTPA; D014580:Ursodeoxycholic Acid; D019786:Gadolinium DTPA