恶性黑色素瘤肝转移的MRI表现

MRI findings of liver metastases in malignant melanoma

目的探讨恶性黑色素瘤肝转移的MRI影像表现,以提高放射科医生对该病的认识及诊断的准确率。方法回顾性分析2017年12月-2020年12月浙江省台州市中心医院收集的9例恶性黑色素瘤肝转移的病例,对患者的MRI影像表现进行分析,复习相关文献,总结其影像特征。结果9例均为肝内多发占位,呈结节、团块状改变,病变信号复杂多样,T1WI上可表现为高信号或低信号或高低混杂信号,T2WI表现为高信号或高低混杂信号或T2WI上显示不明确,DWI呈高信号,少数病灶DWI未见异常高信号,增强扫描呈环状强化,病灶较大者呈蜂窝状改变,病变显示更清晰,少数病灶未见明确强化或强化程度轻微。结论恶性黑色素瘤肝转移的MRI信号表现复杂多样,典型的短T1短T2信号病变,结合原发部位黑色素瘤手术病史,诊断恶性黑色素瘤肝转移相对较容易,而对于不典型的病变,诊断仍有较大难度,最后确诊需要依据病理诊断。

Objective To explore the MRI imaging findings of liver metastasis in malignant melanoma to improve the awareness among radiologists and then improve the accuracy of diagnosis.Methods Nine cases of liver metastasis of malignant melanoma were collected from December 2017 to December 2020,and the patients were analyzed for their MRI imaging performance,collected and reviewed the relevant literature,and summarized their imaging characteristics.Results 9 cases in the liver are multiple space,nodules,mass changes,complex lesion signals,high or low signal or high and low confounding signals on T1WI,T2WI as high signal or high confounding signals or T2WI show unclear,DWI high signal,few lesions DWI no abnormal high signal,enhanced scan ring reinforcement,larger lesions show honeycomb changes,lesions show clearer,a few lesions no clear enhancement or slight enhancement.Conclusion The MRI signal performance of liver metastasis of malignant melanoma is complex and diverse,the typical short T1 short T2 signal lesions,combined with the surgical history of melanoma at the primary site,the diagnosis of malignant melanoma liver metastasis is relatively easy,and the diagnosis of atypical lesions is still difficult to be made,and the final diagnosis is based on the pathological diagnosis.