Iodized oil retention due to postbiopsy arterioportal shunt: a false positive lesion in the investigation of hepatocellular carcinoma

Lim, Jae Hoon; Lee, S. J.; Lee, W. J.; Lim, Hyo Keun; Choo, Sung Wook; Choo, In Wook

doi:10.1007/s002619900468

Cited by 10 publications

(3 citation statements)

References 24 publications

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“…Gd-EOB-DTPA allows superior detection of small lesions compared with contrast-enhanced helical CT [14,19,26], but it is difficult to distinguish between dysplastic nodules and early HCC; dysplastic nodules appear iso-intense to the liver parenchyma due to blood supply from the portal vein [67,68]. Nevertheless, high-grade dysplastic nodules can be regarded as borderline malignancy.…”

Section: Staging Of Carcinogenesismentioning

confidence: 98%

Consensus report of the 2nd International Forum for Liver MRI

et al. 2009

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Discussion at the 2nd Forum for Liver MRI: The International Primovist User Meeting on the use of the hepatocyte-specific contrast agent gadolinium-ethoxybenzyl-diethylene triamine penta-acetic acid (Gd-EOB-DTPA) is reported. Changes to the currently recommended Gd-EOB-DTPA imaging protocol were identified that can reduce the overall examination time. The potential benefits of 3-T MR imaging using Gd-EOB-DTPA have yet to be fully explored. Data show that Gd-EOB-DTPA-enhanced MRI allows identification of liver lesions and provides a differential diagnosis of hepatocellular nodules in the noncirrhotic and cirrhotic liver, based on vascularity, during the dynamic arterial, portal-venous and late phases, and during the hepatocytespecific phase. Current European, American and Japanese guidelines for the diagnosis of hepatocellular carcinoma need to take into account the recent rapid advances in liver imaging. Based on published clinical trials and the experience of the attendees in the use of Gd-EOB-DTPA in liver imaging, a new simplified, non-invasive diagnostic algorithm was proposed that would be applicable to both Eastern and Western clinical practice in the evaluation of hepatocarcinogenesis and hepatocellular carcinoma. Preliminary clinical experience suggests that Gd-EOB-DTPA may also provide an innovative and cost-effective one-stop approach for staging rectal cancer using wholebody imaging.

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Section: Staging Of Carcinogenesismentioning

confidence: 98%

Consensus report of the 2nd International Forum for Liver MRI

et al. 2009

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“…Iodized oil in the hepatic artery reaches the portal system through the shunt, resides in the sinusoid of hepatic lobules, and remains there for up to several weeks. Much more of it is retained there than in the rest of the parenchyma without APS (23). …”

Section: Imaging Findingsmentioning

confidence: 99%

“…The increasing use of interventional radiologic procedures such as percutaneous biopsy (23, 48) (Fig. 3), ethanol injection (26, 49) (Fig.…”

Section: Causesmentioning

confidence: 99%

Hepatic Arterioportal Shunts: Dynamic CT and MR Features

et al. 2002

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With the increased temporal resolution available in dynamic computed tomography (CT) and magnetic resonance imaging (MRI), hepatic arterioportal shunts are now more frequently encountered than in the past. The condition occurs in various hepatic diseases in which portal or hepatic venous flow is compromised. The underlying mechanism and the degree of shunt affect its appearance at dynamic imaging. The dynamic CT and MRI findings have been summarized as early enhancement of peripheral portal veins, and wedge-shaped transient parenchymal enhancement during the hepatic arterial phase. Recognition of arterioportal shunt can suggest the presence of a previously unsuspected disorder and avoids false-positive diagnosis or overestimation of a hepatic disease. Familiarity with the pathophysiology of arterioportal shunt also allows investigation of the hepatic hemodynamic changes occurring in various hepatic diseases.

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