Clinico-Pathological Classification

Piscaglia, Fabio; d’Errico, Angelo; Leoni, Simona; Venturi, A.; Bolondi, Luigi

doi:10.1007/3-540-26354-3_6

Cited by 13 publications

(15 citation statements)

References 48 publications

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“…They lack a terminal central hepatic vein and characteristically show capillarization of sinusoids derived from a feeding artery that is usually larger than normal 43, 44 . On ultrasound, FNH may show very slight changes in echogenicity compared to the surrounding parenchyma and usually appear hypo- or isoechoic and slightly inhomogeneous due to the central scar 45 .…”

Section: Clinical and Radiologic Features Of The Common Liver Mass Lementioning

confidence: 99%

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Venkatesh

Chandan

Roberts

2014

Clinical Gastroenterology and Hepatology

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Liver masses present a relatively common clinical dilemma, particularly with the increasing use of various imaging modalities in the diagnosis of abdominal and other symptoms. The accurate and reliable determination of the nature of the liver mass is critical, not only to reassure individuals with benign lesions but also, and perhaps more importantly, to ensure that malignant lesions are diagnosed correctly. This avoids the devastating consequences of missed diagnosis and the delayed treatment of malignancy or the unnecessary treatment of benign lesions With appropriate interpretation of the clinical history and physical examination, and the judicious use of laboratory and imaging studies, the majority of liver masses can be characterized noninvasively. Accurate characterization of liver masses by cross-sectional imaging is particularly dependent on an understanding of the unique phasic vascular perfusion of the liver and the characteristic behaviors of different lesions during multiphasic contrast imaging. When non-invasive characterization is indeterminate, a liver biopsy may be necessary for definitive diagnosis. Standard histologic examination is usually complemented by immunohistochemical analysis of protein biomarkers. Accurate diagnosis allows the appropriate selection of optimal management, which is frequently reassurance or intermittent follow up for benign masses. For malignant lesions or those at risk of malignant transformation, management depends on the tumor staging, the functional status of the uninvolved liver and technical surgical considerations. Unresectable metastatic masses require oncologic consultation and therapy. The efficient characterization and management of liver masses therefore requires a multidisciplinary collaboration between the gastroenterologist/hepatologist, radiologist, pathologist, hepatobiliary or transplant surgeon, and medical oncologist.

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Section: Clinical and Radiologic Features Of The Common Liver Mass Lementioning

confidence: 99%

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Venkatesh

Chandan

Roberts

2014

Clinical Gastroenterology and Hepatology

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“…Severe adverse reactions occur less frequently than with current CT contrast agents and at roughly the same rate as with MR contrast agents. In a series of 23,188 patients undergoing abdominal CEUS, the rate of lifethreatening allergic reactions was reported to be 0.001%, with no deaths reported and only two patients complaining of serious adverse reactions [10]. Anaphylactoid reactions have been reported to affect 0.014% of patients undergoing CEUS, a rate lower than that of CT (0.035%-0.095%) and comparable to that of MR imaging (0.001%-0.01%) [10][11][12][13][14].…”

Section: Microbubbles: Structure and Principles Of Interaction With Umentioning

confidence: 99%

“…In a series of 23,188 patients undergoing abdominal CEUS, the rate of lifethreatening allergic reactions was reported to be 0.001%, with no deaths reported and only two patients complaining of serious adverse reactions [10]. Anaphylactoid reactions have been reported to affect 0.014% of patients undergoing CEUS, a rate lower than that of CT (0.035%-0.095%) and comparable to that of MR imaging (0.001%-0.01%) [10][11][12][13][14]. UCAs were equally safe for echocardiographic applications [15,16] and for paediatric applications [17].…”

Section: Microbubbles: Structure and Principles Of Interaction With Umentioning

confidence: 99%

General principles and overview of vascular contrast-enhanced ultrasonography

et al. 2020

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Ultrasonography (US) is the first-line modality for the evaluation of vascular pathology. Although well-established for many diseases, US has inherent limitations that can occasionally hinder an accurate diagnosis. The value of US was improved by the introduction of microbubbles as ultrasonographic contrast agents (UCAs) and the emergence of contrast-enhanced ultrasonography (CEUS), following the introduction of second-generation UCAs and the emergence of modern contrast-specific techniques. CEUS offers valuable information about vascular disease, both on a macrovascular and a microvascular level, with well-established applications for carotid disease, post-interventional follow-up of abdominal aortic aneurysms, and the assessment of portal vein thrombosis. The purpose of this review is to discuss the principles of CEUS and to present an overview of its vascular applications.

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“…It is not recommended to perform laboratory tests of renal function before administering them. In a multicenter study of 23,188 patients who had been examined for liver lesions, a serious adverse event rate of 0.0086% was reported, with no deaths and a lifethreatening anaphylactoid reaction rate of less than 0.002% [23]. By comparison, the incidence of serious adverse events is about 0.02%-0.1% after administration of non-ionic X-ray contrast agents and 0.005%-0.2% after administration of gadolinium chelates for MRI [24].…”

Section: Contrast-enhanced Ultrasoundmentioning

confidence: 99%

Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand?

et al. 2019

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Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in ultrasonography (US), and it is being increasingly used for the evaluation of focal liver lesions (FLLs). CEUS is unique in that it allows non-invasive assessment of liver perfusion in real time throughout the vascular phase, which has led to dramatic improvements in the diagnostic accuracy of US in the detection and characterization of FLLs, the choice of therapeutic procedures, and the evaluation of response. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, including in cirrhotic patients with hepatocellular carcinoma, resulting in better patient management and cost-effective delivery of therapy.

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Clinico-Pathological Classification

Cited by 13 publications

References 48 publications

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

Liver Masses: A Clinical, Radiologic, and Pathologic Perspective

General principles and overview of vascular contrast-enhanced ultrasonography

Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand?

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