2021-10-09|閱讀時間 ‧ 約 3 分鐘

[GI] Case 31

    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
    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
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