MR imaging of the abdomen and pelvis PDF
Preview MR imaging of the abdomen and pelvis
MR Imaging of the Abdomen and Pelvis Bernd Hamm, MD Volkmar Nicolas, MD ProfessorofRadiologyandChairman ProfessorofRadiologyandChairman DepartmentofRadiology,CampusMitte DepartmentofDiagnosticandInterventional ClinicofRadiology, RadiologyandNuclearMedicine CampusVirchow-Klinikum BerufsgenossenschaftlichesUniversityHospital Charité–UniversitätsmedizinBerlin Bergmannsheil Berlin,Germany Bochum,Germany Gabriel Paul Krestin, MD Matthias Taupitz, MD ProfessorofRadiologyandChairman ProfessorofRadiologyandPhysicist DepartmentofRadiology DepartmentofRadiology ErasmusMC Charité–UniversitätsmedizinBerlin Rotterdam,theNetherlands Berlin,Germany Michael Laniado, MD ProfessorofRadiologyandChairman DepartmentofDiagnosticRadiology CarlGustavCarusUniversityHospital TechnicalUniversityofDresden Dresden,Germany With contributionsby P.Asbach,D.Beyersdorf,F.Dammann,H.B.Gehl,C.R.Habermann,B.Hamm,C.M.Heyer,C.Klessen, C.Kluener,G.P.Krestin,G.Krupski-Berdien,R.A.Kubik-Huch,M.Laniado,M.Lorenzen,W.Luboldt, A.E.Mahfouz,U.G.Mueller-Lisse,M.R.Muehler,V.Nicolas,W.Pennekamp,P.Reimer,M.Reuter, B.Stoever,M.Taupitz,R.Vosshenrich 1060 illustrations Thieme Stuttgart·NewYork IV LibraryofCongressCataloging-in-PublicationData Importantnote:Medicineisanever-changingscienceundergoing MRTvonAbdomenundBecken.English. continualdevelopment.Researchandclinicalexperiencearecon- MRimagingoftheabdomenandpelvis/BerndHamm...[etal.]; tinuallyexpandingourknowledge,inparticularourknowledgeof withcontributionsbyP.Asbach...[etal.]; propertreatmentanddrugtherapy.Insofarasthisbookmentions [translator,BettinaHerwig]. anydosageorapplication,readersmayrestassuredthattheauthors, p.;cm. editors,andpublishershavemadeeveryefforttoensurethatsuch Includesbibliographicalreferencesandindex. referencesareinaccordancewiththestateofknowledgeatthetime ISBN978-3-13-145591-8(alk.paper) ofproductionofthebook. 1. Abdomen--Magneticresonanceimaging.2. Pelvis--Magnetic Nevertheless,thisdoesnotinvolve,imply,orexpressanyguar- resonanceimaging. I.Hamm,Bernd,Prof.Dr.II.Title. anteeorresponsibilityonthepartofthepublishersinrespecttoany [DNLM:1.Abdomen--pathology.2.MagneticResonanceImaging. dosageinstructionsandformsofapplicationsstatedinthebook. 3. Pelvis--pathology. WI900M93952009a] Every user is requested to examine carefully the manufacturers’ RC944.M66132009 leafletsaccompanyingeachdrugandtocheck,ifnecessaryincon- 617.5'507548--dc22 sultationwithaphysicianorspecialist,whetherthedosagesched- 2009018513 ulesmentionedthereinorthecontraindicationsstatedbytheman- ufacturersdifferfromthestatementsmadeinthepresentbook.Such Thisbookisanauthorizedandrevisedtranslationofthe2nd examination is particularly important with drugs that are either Germaneditionpublishedandcopyrighted2007byGeorgThieme rarely used or have been newly released on the market. Every Verlag,Stuttgart,Germany.TitleoftheGermanedition:MRTvon dosage schedule or every form of application used is entirely at AbdomenundBecken theuser’sownriskandresponsibility.Theauthorsandpublishers requesteveryusertoreporttothepublishersanydiscrepanciesor Translator:BettinaHerwig,Berlin,Germany inaccuraciesnoticed.Iferrorsinthisworkarefoundafterpublica- tion, errata will be posted at www.thieme.com on the product Illustrators:StefanieGayandBertSender,Bremen,Germany descriptionpage. ©2010GeorgThiemeVerlag, Someoftheproductnames,patents,andregistereddesignsreferred Rüdigerstrasse14,70469Stuttgart,Germany to in this book are in fact registered trademarks or proprietary http://www.thieme.de names even though specific reference to this fact is not always ThiemeNewYork,333SeventhAvenue, made in the text. Therefore, the appearance of a name without NewYork,NY10001,USA designationasproprietaryisnottobeconstruedasarepresentation http://www.thieme.com bythepublisherthatitisinthepublicdomain. This book, including all parts thereof, is legally protected by Coverdesign:ThiemePublishingGroup copyright.Anyuse,exploitation,orcommercializationoutsidethe TypesettingbyprimustypeHurler,Notzingen,Germany narrowlimitssetbycopyrightlegislation,withoutthepublisher’s PrintedinGermanybyAPPLaprintadruck,Wemding consent,isillegalandliabletoprosecution.Thisappliesinparticular tophotostatreproduction,copying,mimeographing,preparationof ISBN978-3-13-145591-8 123456 microfilms,andelectronicdataprocessingandstorage. V Preface Magneticresonanceimaginghasdevelopeddramatically be aware that the specific contrast media may not have inrecentyears,andthetechnicaladvanceshaveexpanded been approved for all countries or continents and that therangeofdiagnosticapplications.Intheabdomenand theirapprovalstatusissubjecttochange. pelvis,MRIhaslongdevelopedbeyondtheexperimental WorkingonthisEnglisheditionhasmadeusawareof stageandisnowthemethodofchoiceformanyindica- how difficult it is to keep abreast of technical develop- tions.Withincreasingexperience,refinedandhighlyspe- mentsinsuchadynamicfieldasMRI.Thus,newinsights cializedimagingtechniqueshaveemergedforthediffer- at the time of publication might already have outpaced entorgansystems,makingMRIoftheabdomenandpelvis thestateoftheartatthetimeofwriting. acomplexfieldofitsown. Many radiologists directly involved in the scientific This book provides a comprehensive overview of the developmentofabdominaland pelvicMRI,eitherinco- technicallydemanding,interesting,andclinicallyrelevant operation with us or as independent researchers, have fieldofabdominopelvicMRI.Eachorganororgansystem contributed to this book as authors or co-authors. We istreatedinaseparatechapterthatcanbereadindepend- thank all of them for their dedicated, supportive, and entlyandbeginswithaconcisedescriptionofthespecific inspiring cooperation. Our thanks also go to the staff of imagingtechnique. Thieme Publishers for making possible this English edi- Theindividualchapterscanbereadasacookbookwith tionandtoBettinaHerwigforthetranslation. regardtothespecificimagingtechniqueandindications Wehopethatthisbookwillbeausefulresourcetoour forMRI.Thepresentationofpathologicentitiesislavishly colleagues interested in abdominal and pelvic MRI and illustrated and iscompleted byadescriptionof theMRI helpthemmakeuseofMRItothebenefitofourpatients. findingsanddifferentialdiagnoses. UniquetoMRI,especiallyofthehepatobiliarysystem, B.Hamm istheavailabilityofalargenumberofcontrastagents.MRI G.P.Krestin of the liver can be performed with different nonspecific M.Laniado contrastmedia,whichareavailableallovertheworld,or V.Nicolas withoneofseveraltissue-specificagents.Readersshould M.Taupitz VI Contributors PatrickAsbach,MD ClaudiaKluener,MD AssistantProfessorofRadiology DepartmentofRadiologyandNeuroradiology DepartmentofRadiology OldenburgEvangelicalHospital Charité–UniversitätsmedizinBerlin Oldenburg,Germany Berlin,Germany GerritKrupski-Berdien,MD DirkBeyersdorff,MD ProfessorofRadiology AssociateProfessorRadiology DepartmentofDiagnosticandInterventionalRadiology DepartmentofRadiology ReinbekSt.Adolf-StiftHospital Charité–UniversitätsmedizinBerlin Reinbek,Germany Berlin,Germany RahelA.Kubik-Huch,MD FlorianDammann,MD ProfessorofRadiology ProfessorofRadiology DepartmentofRadiology DepartmentofRadiology KantonsspitalBadenAG KlinikamEichert Baden,Switzerland Göppingen,Germany MarenLorenzen,MD Hans-BjoernGehl,MD RadiologyPracticeHeegbarg ProfessorofRadiology Hamburg,Germany DepartmentofRadiology Bielefeld-MitteCityHospitals WolfgangLuboldt,MD,MSc Bielefeld,Germany AssociateProfessorofRadiologyandNuclearMedicine Physicist ChristianR.Habermann,MD DepartmentofRadiology AssociateProfessorofRadiology UniversityHospitalFrankfurt DiagnosticCenter,DepartmentofDiagnostic Frankfurta.M.,Germany andInterventionalRadiology UniversityMedicalCenterHamburg-Eppendorf Ahmed-EmadMahfouz,MD Hamburg,Germany ProfessorofRadiology HamadMedicalCorporation ChristophM.Heyer,MD RadiologyDepartment AssociateProfessorofRadiology Doha,Quatar DepartmentofDiagnosticandInterventionalRadiology andNuclearMedicine MatthiasR.Muehler,MD BerufsgenossenschaftlichesUniversityHospital AssistantProfessorofRadiology Bergmannsheil DepartmentofRadiology Bochum,Germany Charité–UniversitätsmedizinBerlin Berlin,Germany ChristianKlessen,MD CenterforDiagnosticRadiologyand UllrichGerdMueller-Lisse,MD MinimallyInvasiveTherapy AssociateProfessorofRadiology TheJewishHospitalBerlin DepartmentofClinicalRadiology Berlin,Germany MunichUniversityHospital,Innenstadt Munich,Germany Contributors VII WernerPennekamp,MD MichaelReuter,MD AssistantProfessorofRadiology ProfessorofRadiology DepartmentofDiagnosticandInterventionalRadiology DepartmentofRadiologyandInterventionalTreatment andNuclearMedicine VivantesHospitalNeukölln BerufsgenossenschaftlichesUniversityHospital Berlin,Germany Bergmannsheil Bochum,Germany BrigitteStoever,MD ProfessorofRadiology PeterReimer,MD DepartmentofPediatricRadiology ProfessorofRadiology Charité–UniversitätsmedizinBerlin DepartmentofRadiology Berlin,Germany KarlsruheMunicipalHospital AcademicTeachingHospitaloftheUniversityofFreiburg RolfVosshenrich,MD Karlsruhe,Germany ProfessorofRadiology MRIPracticeFriederikenstift Hanover,Germany VIII Abbreviations 1D,2D,3D One-dimensional,two-dimensional,three- Gd-BOPTA Gadobenicacid(relaxation-enhancing dimensional componentoftheMRcontrastmedium Multihance) ACTH Adrenocorticotropichormone Gd-DOTA Gadoterate(relaxation-enhancingcompo- ADPKD Autosomaldominantpolycystickidney nentoftheMRcontrastmediumDotarem) disease Gd-DTPA Gadopentetate(relaxation-enhancing ASSET Arrayspatialsensitivityencoding componentoftheMRcontrastmedium technique Magnevist) Gd-DTPA-BMAGadodiamide(relaxation-enhancingcom- BPH Benignprostatichyperplasia ponentoftheMRcontrastmediumOm- BCS Budd–Chiarisyndrome niscan) Gd-EOB-DTPA Gadoxeticacid(relaxation-enhancing CCA Cholangiocarcinoma componentoftheMRcontrastmedium CCC Cholangiocellularcarcinoma Primovist) CNR Contrast-to-noiseratio Gd-HP-DO3A Gadoteridol(relaxation-enhancingcompo- CSF Cerebrospinalfluid nentoftheMRcontrastmediumMulti- CSI Chemicalshiftimaging hance) CT Computedtomography GI Gastrointestinal CTA Computedtomographyangiography GIST Gastrointestinalstromaltumor CTAP Computedtomographyduringarterial GMR Gradientmomentrephasing portography GRASE Gradientspinecho D&C Dilatationandcurettage GRASS Gradient-recalledacquisitioninasteady state DER Digitalrectalexamination GRE Gradientecho DRG Diagnosis-relatedgroup DSA Digitalsubtractionangiography HASTE HalfFourier-acquiredsingleshotturbospin DWI Diffusion-weightedimaging echo HCC Hepatocellularcarcinoma EPI Echoplanarimaging HF Highfrequency ERCP Endoscopicretrogradecholangiopancrea- IMH Intramuralhematoma tography IMHN Intraductalmucin-hypersecretingneopla- ETL Echotrainlength sia FAST Fourier-acquiredsteadystate IP In-phase FE Fieldecho iPAT Integratedparallelacquisitiontechniques FFE Fastfieldecho IPMT Intraductalpapillarymucinoustumor FID Freeinductiondecay IR Inversionrecovery FISP Fastimagingwithsteadystatefree IUD Intrauterinedevice precession IV Intravenous FLASH Fastlowangleshot FNH Focalnodularhyperplasia MEN Multipleendocrineneoplasia FOV Fieldofview MFH Malignantfibroushistiocytoma FS Fatsuppression,fat-suppressed MIP Maximumintensityprojection FSE Fastspinecho Mn-DPDP Mangafodipir(relaxation-enhancingcom- ponentoftheMRcontrastmediumTesla- Gd Gadolinium scan) Abbreviations IX MPR Multiplanarreconstruction/reformation s Second MP-RAGE Magnetization-preparedrapidacquisition SAR Specificabsorptionrate gradientecho SCT Spiralcomputedtomography MPS Mononuclearphagocytesystem SE Spinecho MRA Magneticresonanceangiography SENSE Sensitivityencoding MRC Magneticresonancecolonography SI Signalintensity MRCP Magneticresonancecholangiopancreatog- SIRS Systemicinflammatoryresponsesyndrome raphy SNR Signal-to-noiseratio MRE Magneticresonanceelastography SPGR SpoiledGRASS MRI Magneticresonanceimaging SPIO Superparamagneticironoxide MRS Magneticresonancespectroscopy SPIR Spectralpresaturationbyinversion MRSI Magneticresonancespectroscopicimaging SR Saturationrecovery MRU Magneticresonanceurography SSD Shadedsurfacedisplay ms Millisecond SSFP Steadystatefreeprecession MSCT Multislicespiralcomputedtomography SSFSE Singleshotfastspinecho NASH Nonalcoholicsteatohepatitis STEAM Stimulatedechoacquisitionmode NEX Numberofexcitations STIR Shorttauinversionrecovery NHL Non-Hodgkinlymphoma NSF Nephrogenicsystemicfibrosis T Tesla T1w,T2w T1-weighted,T2-weighted OP Opposed-phase T2* EffectiveT2relaxationtime(T2star) TCC Transitionalcellcarcinoma PACE Prospectiveacquisitioncorrection TE Timetoecho(echotime) PAU Penetratingatheroscleroticulcer TEE Transesophagealechocardiography PBC Primarybiliarycirrhosis TFE Turbofieldecho PBS Primarybiliarysclerosis TI Timetoinversion(inversiontime) PC Phasecontrast TIM Totalimagingmatrix PCOS Polycysticovarysyndrome TIPS Transjugularintrahepaticportosystemic PD Protondensity shunt PET Positronemissiontomography TIRM Turboinversionrecoverymagnitude PID Pelvicinflammatorydisease TME Totalmesorectalexcision PIN Prostaticintraepithelialneoplasm TOF Timeofflight PNET Primitiveneuroectodermaltumor TR Timetorepetition(repetitiontime) ppm Partspermillion TRUS Transrectalultrasound PRESS Point-resolvedspectroscopy TVUS Transvaginalultrasound PSA Prostate-specificantigen TSE Turbospinecho PSC Primarysclerosingcholangitis TUR Transurethralresection PSIF InvertedFISP TURP Transurethralresectionoftheprostate PTC Percutaneoustranshepaticcholangiogra- phy UAE Uterinearteryembolization PWI Perfusion-weightedimaging US Ultrasound USPIO Ultra-smallsuperparamagneticironoxide RARE Rapidacquisitionwithrelaxationen- hancement VIBE Volume-interpolatedbreath-holdexami- RAS Renalarterystenosis nation RCC Renalcellcarcinoma VIP Vasoactiveintestinalpolypeptide ROI Regionofinterest VOI Volumeofinterest ROPE Respiratoryorderingofphaseencoding RPF Retroperitonealfibrosis
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