Case 201

 A seventy seven-year-old female periodically (once per two months) presented in our hospital for follow-up after endoscopic intraperitoneal tumor resection for sigmoid cancer three years before. After excision, she was given anticancer drugs. However, distant lung metastasis was found last year and then, she received re-surgical resection for metastatic lung tumor. Laboratory test revealed CEA 3.2 mg/dL and CA19-9, 10 U/mL. She received periodic contrast-enhanced abdominal CT (Figs 1- 4) and thereafter, Gd-enhanced MRI (Figs 5 – 10) to check local recurrence or distant metastasis.

What is the most appropriate imaging on CT to demonstrate the minute liver metastasis ?

1.　Non-enhanced CT

2.　Arterial phase of contrast-enhanced CT

3.　Portal phase of contrast-enhanced CT

4.　Capillary phase of contrast-enhanced CT

5.　All

What is the most appropriate sequence MRI to demonstrate the minute liver metastasis ?

1.　Diffusion WI

2.　T1WI

3.　T2WI

4.　Arterial phase of Gd-MRI

5.　Portal phase of Gd-MRI

6.　Capillary phase of Gd-MRI

7.　Hepatic cell phase of Gd-MRI

answer

2020.8.19