一個65 歲男性,有Congestive heart failure 病史,影像學:未打顯影劑的CT
Hyperdense liver parenchyma, with >80HU
看到hyperdense liver density,聯想:Amiodarone toxicity, Iron deposition, Glycogen storage disease, Gold therapy(現在少), thorotrast (現在少)
- Amiodarone therapy: 心律不整用藥,可能會有心臟病史。除hyperdense liver外,也可能伴隨有lower lung ILD, 以及focal lung infiltrates with increased attenuation.
- Iron deposition: 可能成因有口福攝取太多,多次輸血,血液疾病(thalassemia, sideroblastic anemia), primary hemochromatosis. 除高亮度外,可能可以發現hepatic enlargement, cirrhosis。
- Glycogen storage disease: type I and IV有關。
***從MRI 來看
- Primary hemochromatosis: liver, myocardium anf pancreas T2WI 比較暗,
- Secondary hemochromatosis: liver and splen T2WI 暗
- Glycogen storage disease: T1WI 亮
***其他注意事項:看到hyperdense liver 想到HCC and angiosarcoma 比例可能會上升,特別要注意有無tumor
Ans: amiodarone therapy