MR Imaging of Benign Focal Liver Lesions

Cogley, Jonathan R.; Miller, Frank H.

doi:10.1016/j.rcl.2014.02.005

Cited by 52 publications

(56 citation statements)

References 100 publications

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“…However, also serous variants may occur. It is predominantly found in females where ovarian stroma may be present [21]. The tumor accounts for about 5% of all cystic liver lesions originating from the bile ducts.…”

Section: Cystadenoma and Cystadenocarcinomamentioning

confidence: 99%

“…The differentiation between cystadenoma and cystadenocarcinoma may be difficult but is of lesser clinical importance since both entities require complete surgical resection [21,23].…”

Section: Cystadenoma and Cystadenocarcinomamentioning

confidence: 99%

“…Cystadenomas are T2 hyperintense and may have varying signal on T1-weighted images caused by blood or protein rich content [21]. Contrast enhancement of the solid tumor components may occur and is better evaluated on MRI than on CT as well as its relation to the bile ducts [21].…”

Section: Cystadenoma and Cystadenocarcinomamentioning

confidence: 99%

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Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

et al. 2012

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Background Surgical treatment is the only option for long-term survival in patients with colorectal liver metastasis (CRLM). Contrast-enhanced CT and MRI are usually used for preoperative liver imaging. The initial surgical strategy for liver resection is based upon these findings. Further optimization of the surgical strategy by contrast-enhanced intraoperative ultrasound (CE-IOUS) might further improve the surgical outcome. Purpose To evaluate the current impact of CE-IOUS with SonoVue® on the initial surgical strategy for CRLM. Material and Methods Eighty-six consecutive patients undergoing open liver resection for CRLM were evaluated retrospectively over a 2.5-year period. The patients underwent 97 operations. Preoperative staging was performed with contrast-enhanced CT in all patients and MRI was available in 66 of 86 patients. CE-IOUS was performed in all patients according to a standardized examination technique. Curved array and linear transducers were used. CRLM were identified in venous phase as hypovascular lesions. CE-IOUS findings were compared with preoperative staging. Results Combined CT/MRI identified preoperatively 328 CRLM (mean 3.4, range 0-14). Seventy-two additional lesions (18%) were identified in 38 patients during the operation. Intraoperatively 41 additional CRLM in 20 patients were identified by inspection, palpation, and CE-IOUS (10%), and another 31 CRLM in 17 patients were identified by CE-IOUS alone (8%). All additional CRLM detected by CE-IOUS were confirmed by histology if resection was performed. CE-IOUS changed planned operation strategy in 29.9% of operations. A larger resection was necessary in 13.4% of the cases, reduced liver resection was found sufficient in 11.3%, and 5.2% were found inoperable. For patients diagnosed preoperatively with solitary lesions CE-IOUS changed operation strategy in 19% and radical tumor resection would have failed in 4.8% without CE-IOUS. Conclusion CE-IOUS is essential to ensure optimal and complete tumor resection both in patient with solitary CRLM and multiple metastases.

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Section: Cystadenoma and Cystadenocarcinomamentioning

confidence: 99%

“…The differentiation between cystadenoma and cystadenocarcinoma may be difficult but is of lesser clinical importance since both entities require complete surgical resection [21,23].…”

Section: Cystadenoma and Cystadenocarcinomamentioning

confidence: 99%

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Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

et al. 2012

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“…Magnetic resonance imaging is a highly precise, non invasive modality for diagnosis of hepatic hemangiomas, with ~90% sensitivity and 91%-99% specificity. The typical appearance of a hemangioma on MRI is that of a smooth, homogeneous, welldemarcated mass, hypointense on T1 and hyperintense on T2weighted sequences (26,27) . The presence of fibrosis within the tumor is visualized as hypointense areas on T2 imaging.…”

Section: Hepatic Hemangiomasmentioning

confidence: 99%

“…As in CT imaging, this progressive centripetal fillin pattern is typical of the majority of heman giomas >2 cm in size; tumors smaller than 2 cm may exhibit homogeneous contrast filling during the initial phase. Small hemangiomas that exhibit rapid, uniform contrast uptake are sometimes indistinguishable from hypervascular metastases and hepatocellular carcinoma (27) . Despite its high specificity, the technetium99m ( 99m Tc)labeled red blood cell scan has fallen into disuse, as has hepatic angiography.…”

Section: Hepatic Hemangiomasmentioning

confidence: 99%

Diagnosis and treatment of benign liver nodules: Brazilian Society of Hepatology (SBH) recommendations

Strauss

Ferreira

França

et al. 2015

Arq. Gastroenterol.

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-Spaceoccupying lesions of the liver may be cystic or solid. Ultrasonography is an extremely useful method for initial screening, and suffices for diagnosis of simple hepatic cysts. Complex cysts and solid masses require computed tomography or magnetic resonance imaging for confirmation. Wide surgical excision is indicated in cystadenoma or cystadenocarcinoma. Clinical and epidemiological data are important, as nodules in noncirrhotic livers are more likely to be benign. Hemangiomas, the most common benign tumors, require no followup after diagnostic confirmation if they are small and asymptomatic. Patients with giant, symptomatic hemangiomas or compression of adjacent structures should be referred to hepatobiliary centers for potential surgery. The genetic heterogeneity of hepatocellular adenomas and their epidemiology and prognosis prompted classification of these tumors into four subtypes based on histology and immunohistochemistry. The major complications of hepatocellular adenomas are rupture with bleeding and malignant transformation. Rupture occurs in approximately 30% of cases. The main risk factors are tumor size >5 cm and inflammatory subtype. Hepatocellular adenomas may enlarge during pregnancy due to marked hormonal stimulation. As oral contraceptive pills and anabolic steroids have been associated with hepatocellular adenomas growth, particularly of the hepatocyte nuclear factor1alfa subtype, these drugs should be discontinued. Focal nodular hyperplasia is the second most common benign tumor of the liver. It is most frequent in women aged 20 to 60, and 70% to 90% of cases are asymptomatic. In the absence of a central scar and/or other hallmarks of Focal nodular hyperplasia, with uncertainty between this diagnosis and hepatocellular adenoma, liverspecific contrast agents are indicated.

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Magnetic Resonance Imaging

Bergin¹,

Mitchell²

2015

Yamada' S Textbook of Gastroenterology

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MR Imaging of Benign Focal Liver Lesions

Cited by 52 publications

References 100 publications

Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

Impact of Contrast-Enhanced Intraoperative Ultrasound on Operation Strategy in Case of Colorectal Liver Metastasis

Diagnosis and treatment of benign liver nodules: Brazilian Society of Hepatology (SBH) recommendations

Magnetic Resonance Imaging

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