A major role of the radiologist in evaluating hepatic neoplasms is to assist the surgeon in determining the feasibility of hepatic resection. Disease confined to the liver must be accurately localized relative to important intrahepatic structures, particularly those that determine hepatic segmental anatomy [1 , 2]; moreover, extrahepatic spread must be defined if present. The first part of this essay reviews normal hepatic vascular anatomy and its relationship to segmental anatomy, as seen on CT, MR imaging, and sonography. Emphasis is placed on the formation of a three-dimensional concept of hepatic vascular and segmental anatomy. Such a concept is essential in real-time sonography, since the liver is imaged in nonorthogonal planes. Moreover, it enables the radiologist to take full advantage of sagittal and coronal images when evaluating the liver with MR imaging.
Materials and MethodsWe selected CT, MR, and sonographic images that demonstrate normal anatomy to highlight vascular and segmental anatomy. The
Real-time ultrasound (US)-guided biopsies and drainage procedures require constant visualization of the needle tip. Ensuring optimum needle tip visualization is paramount to the success of these procedures. The authors have found that pumping the stylet in and out of a stationary needle shaft increases the echo-genicity of the needle shaft and tip, thereby facilitating needle localization. This technique, which we have termed "the pump maneuver," is a quick, useful, and atraumatic adjunct to be considered during US-guided percutaneous needle biopsy and drainage procedures.
The authors report a case of a hepatic artery aneurysm that simulated a mass in the head of the pancreas. The correct diagnosis was made preoperatively based on several findings: curvilinear calcification within the mass on CT, a well-defined cystic collection on ultrasound, absence of biliary duct dilatation or jaundice, and presence of other aneurysms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.