Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment – Part 2

Ramalho, Miguel; Matos, António P.; AlObaidy, Mamdoh; Velloni, Fernanda; Altun, Ersan; Semelka, Richard C.

doi:10.1590/0100-3984.2015.0140

Cited by 12 publications

(8 citation statements)

References 57 publications

(75 reference statements)

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“…We prospectively analyzed 100 consecutive CT angiography examinations of the abdomen performed at the General Hospital of Fortaleza over a one-year period. The imaging evaluation of the rhino-orbital region has been the object of a series of recent publications in the radiology literature of Brazil 24 - 29 .…”

Section: Discussionmentioning

confidence: 99%

Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

et al. 2018

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Objective To describe the main anatomical variations of the celiac trunk and the hepatic artery at their origins.Materials and Methods This was a prospective analysis of 100 consecutive computed tomography angiography studies of the abdomen performed during a one-year period. The findings were stratified according to classification systems devised by Sureka et al. and Michels.Results The celiac trunk was "normal" (i.e., the hepatogastrosplenic trunk and superior mesenteric artery originating separately from the abdominal aorta) in 43 patients. In our sample, we identified four types of variations of the celiac trunk. Regarding the hepatic artery, a normal anatomical pattern (i.e., the proper hepatic artery being a continuation of the common hepatic artery and bifurcating into the right and left hepatic arteries) was seen in 82 patients. We observed six types of variations of the hepatic artery.Conclusion We found rates of variations of the hepatic artery that are different from those reported in the literature. Our findings underscore the need for proper knowledge and awareness of these anatomical variations, which can facilitate their recognition and inform decisions regarding the planning of surgical procedures, in order to avoid iatrogenic intraoperative injuries, which could lead to complications.

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Section: Discussionmentioning

confidence: 99%

Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

et al. 2018

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“…Compared with dynamic enhanced CT and enhanced MRI of Gd-DTPA, the enhanced MRI of Gd-EOB-DTPA has higher detection sensitivity for the diagnosis of HCC with rich or poor blood supply [ 15 ]. Compared with other imaging methods, Gd-EOB-DTPA-enhanced MRI can significantly improve the detection rate and diagnostic accuracy for early liver cancer [ 26 ]. Although the feasibility of conventional enhanced MRI in the diagnosis of HCC has been widely recognized, the accuracy and sensitivity for the diagnosis of small HCC with a diameter of < 2.0 cm remains inadequate [ 27 ] and fails to fully meet clinical needs.…”

Section: Main Textmentioning

confidence: 99%

Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma

et al. 2020

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Background: Hepatocellular carcinoma (HCC) is the most common malignant tumor of the liver, and its morbidity and mortality have been increasing in recent years. The early diagnosis and prompt treatment of small HCC are crucial to improve the prognosis and quality of life of patients. In China, hepatitis B virus infection is the main cause. HCC with a single tumor nodule of ≤ 3 cm in diameter, or HCC with a number of nodules, in which each nodule is ≤ 2 cm in diameter, with a total diameter of ≤ 3 cm, is considered as small HCC. The MRI liver-specific contrast agent can detect small HCC at the early stage. This has important clinical implications for improving the survival rate of patients. Main body: Gd-EOB-DTPA-enhanced MRI can significantly improve the sensitivity and specificity of the detection of HBV-related small hepatocellular carcinoma, providing an important basis for the clinical selection of appropriate personalized treatment. Gd-EOB-DTPA-enhanced MRI can reflect the degree of HCC differentiation, and the evaluation of HCC on Gd-EOB-DTPA-enhanced MRI would be helpful for the selection of the treatment and prognosis of HCC patients. The present study reviews the progress of the application of Gd-EOB-DTPA in the early diagnosis of small HCC, its clinical treatment, the prediction of the degree of differentiation, and the assessment of recurrence and prognosis of HCC, including the pharmacoeconomics and application limitations of Gd-EOB-DTPA. The value of the application of HCC with the Gd-EOB-DTPA was summarized to provide information for improving the quality of life and prolonging the survival of patients. Conclusion: Gd-EOB-DTPA-enhanced MRI has the diagnostic capability for small HCC with a diameter of ≤ 2 cm. This will have a broader application prospect in the early diagnosis of small liver cancer with a diameter of ≤ 1 cm in the future. The relationship between GD-EOB-DTPA-MRI and the degree of HCC differentiation has a large research space, and Gd-EOB-DTPA is expected to become a potential tool for the preoperative prediction and postoperative evaluation of HCC, which would be beneficial for more appropriate treatments for HCC patients.

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“… 9 So, any T2 elongation in at-risk patients should be considered as highly suggestive of a malignancy. 55 Evidence have shown that T2-weighted imaging is particularly valuable together with diffusion-weighted imaging (DWI) for differentiating between small atypical HCCs (<3 cm) and dysplastic nodules, 56 as the presence of mild-moderate T2 hyperintensity or restricted diffusion strongly favors the diagnosis of a malignant nodule in cirrhotic patients, even if the typical feature of the arterial hyperenhancement is still missing. 10 …”

Section: Ancillary Featuresmentioning

confidence: 99%

“…Although it is relatively uncommon (having a sensitivity for HCC of 12–37%), this feature has a high specificity for HCC (68–100%); hence, in a high-risk population, the detection of intralesional fat in a solid hepatic nodule should raise concerns for HCC. 23 , 55 , 89 …”

Section: Ancillary Featuresmentioning

confidence: 99%

CT-MRI LI-RADS v2017: A Comprehensive Guide for Beginners

Patella

Pesapane

Fumarola

et al. 2018

Journal of Clinical and Translational Hepatology

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Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and the second leading cause of cancer-related deceases worldwide. Early diagnosis is essential for correct management and improvement of prognosis. Proposed for the first time in 2011 and updated for the last time in 2017, the Liver Imaging-Reporting and Data System (LI-RADS) is a comprehensive system for standardized interpretation and reporting of computed tomography (CT) and magnetic resonance imaging (MRI) liver examinations, endorsed by the American College of Radiology to achieve congruence with HCC diagnostic criteria in at-risk populations. Understanding its algorithm is fundamental to correctly apply LI-RADS in clinical practice. In this pictorial review, we provide a guide for beginners, explaining LI-RADS indications, describing major and ancillary features and eventually elucidating the diagnostic algorithm with the use of some clinical examples.

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Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment – Part 2

Cited by 12 publications

References 57 publications

Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

Computed tomography angiography study of variations of the celiac trunk and hepatic artery in 100 patients

Application of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma

CT-MRI LI-RADS v2017: A Comprehensive Guide for Beginners

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