The value of gadoxetic acid-enhanced MRI for differentiation between hepatic microabscesses and metastases in patients with periampullary cancer

Choi, Sung Yong; Kim, Young Kon; Min, Ji Hye; Ik, Dong; Jeong, Woo Kyoung; Lee, Won Jae

doi:10.1007/s00330-017-4782-3

Cited by 18 publications

(20 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Diagnosing liver metastasis is a challenge in EHD cancer patients because small biliary abscesses frequently coexist due to biliary obstruction. The findings from previous studies suggest that patchy parenchymal enhancement, arterial rim enhancement persistent through portal venous phase and perilesional hyperemia on CT and MR, and size discrepancy between T1WI and T2WI as well as T1WI and the hepatobiliary phase on MR are indicative of biliary abscess rather than liver metastasis (108,109). Short-term follow-up with imaging can also help radiologists to assess lesional size changes.…”

Section: Kq 10 How Do We Evaluate Distant Metastasis In Extrahepatic Bile Duct Cancer?mentioning

confidence: 99%

Radiologic Evaluation and Structured Reporting Form for Extrahepatic Bile Duct Cancer: 2019 Consensus Recommendations from the Korean Society of Abdominal Radiology

et al. 2021

Self Cite

View full text Add to dashboard Cite

Radiologic imaging is important for evaluating extrahepatic bile duct (EHD) cancers; it is used for staging tumors and evaluating the suitability of surgical resection, as surgery may be contraindicated in some cases regardless of tumor stage. However, the published general recommendations for EHD cancer and recommendations guided by the perspectives of radiologists are limited. The Korean Society of Abdominal Radiology (KSAR) study group for EHD cancer developed key questions and corresponding recommendations for the radiologic evaluation of EHD cancer and organized them into 4 sections: nomenclature and definition, imaging technique, cancer evaluation, and tumor response. A structured reporting form was also developed to allow the progressive accumulation of standardized data, which will facilitate multicenter studies and contribute more evidence for the development of recommendations.

show abstract

Section: Kq 10 How Do We Evaluate Distant Metastasis In Extrahepatic Bile Duct Cancer?mentioning

confidence: 99%

Radiologic Evaluation and Structured Reporting Form for Extrahepatic Bile Duct Cancer: 2019 Consensus Recommendations from the Korean Society of Abdominal Radiology

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…The DWI high signal in the center of the hepatic abscess lesions could be explained by the increased restriction of diffusion of high-viscosity pus in the central area. 20 In our study, there were only two (4.7%) cases of atypical hepatic abscesses with high SI and ADC values, an effect known as “T2 shine-through,” while the surrounding area of the malignant tumors showed diffusion limitation. Abscesses can lead to decreased cellularity and increased extracellular fluid in the periphery, secondary to inflammation, leading to prolonged T2 relaxation time without diffusion restriction.…”

Section: Discussionmentioning

confidence: 48%

“…Choi et al have found that parts of hepatic microabscesses are invisible on unenhanced T1-weighted images (T1WIs). 20 Recent evidence has suggested a non-defect of the arterial enhancing rim on hepatobiliary phase imaging (HBPI) in gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid–enhanced MRI, which means the SI of the rim may be lower than that of the surrounding liver parenchyma and higher than that of the central portion. 14 In other words, the boundary between the liver parenchyma and abscess is blurred due to the same SI.…”

Section: Introductionmentioning

confidence: 99%

Differentiating Between an Atypical Hepatic Abscess and Tumor Metastasis Using Magnetic Resonance Imaging and Hepatobiliary Phase Imaging

Zhuo¹,

Xing²,

Ma³

et al. 2021

IDR

View full text Add to dashboard Cite

Objective To identify diffusion-weighted imaging (DWI) patterns and conspicuity discrepancies on hepatobiliary phase imaging (HBPI) to distinguish atypical hepatic abscesses from hepatic metastases. Materials and Methods This retrospective study recruited 31 patients with 43 atypical hepatic abscesses and 32 patients with 35 hepatic metastases who underwent gadobenate dimeglumine-enhanced magnetic resonance imaging. All lesions were confirmed by pathological or clinical diagnosis. For the qualitative and quantitative analyses, the signal intensity, DWI pattern, apparent diffusion coefficient, degree of perilesional edema, perilesional hyperemia, perilesional signal on HBPI, conspicuity, size discrepancy between sequences, contrast-to-noise ratio, signal-to-noise ratio, and relative enhancement ratio on dynamic phases were independently assessed by two radiologists. Significant findings for differentiating the two groups were identified via univariate and multivariate analyses with a nomogram for predicting atypical hepatic abscesses. The interobserver agreement was also analyzed for each variable. Results The multivariate analysis revealed that the conspicuity discrepancy (odds ratio [OR] 34.78, 95% confidence interval [CI] 2.09–579.47, p = 0.013) and non-peripheral high signal intensity (SI) rim on DWI (OR 67.46, 95% CI 2.64, 1723.20, p = 0.011) were significant independent factors for predicting atypical hepatic abscesses. They were also shown to be high predictor points on the nomogram. When any of the set criteria were satisfied, 97.7% of atypical hepatic abscesses were correctly identified, with a specificity of 65.7%. When both criteria were combined, the specificity was up to 100%, with a sensitivity of 44.9%. Conclusion Conspicuity discrepancy and a non-peripheral high SI rim on DWI are reliable and meaningful features that can distinguish atypical hepatic abscesses from hepatic metastases.

show abstract

“…Only on day 7 were the lesions observed. In such cases, contrast MRI is considered more accurate in de ining and characterizing the indings [23]. Truly, a subsequent MRI established the diagnosis of micro-abscesses in the present case.…”

Section: Discussionmentioning

confidence: 56%

A unique case of metastatic spinal epidural abscess associated with liver abscess following ascending cholangitis and Escherichia coli bacteremia

Karra¹,

Ganam²,

Bickel³

et al. 2019

Arch Surg Clin Res

View full text Add to dashboard Cite

Pyogenic liver abscess (PLA) is a life-threatening infection that may develop as a result of an underlying hepatobiliary disease. A possible complication of PLA is metastatic spread, resulting in distant seeding of infection in other organs, and occasionally in the epidural space. Spinal epidural abscess (SEA) is a rare infection with severe potential complications. We describe a 71-year-old patient who presented with ascending cholangitis that was complicated by micro PLA, with a subsequent Escherichia coli bacteremia and metastatic SEA. An emergent surgical intervention with laminotomy and drainage of the epidural collection was performed. The patient was treated with a prolonged antibiotic regimen, with uneventful recovery and no neurologic sequelae. To our knowledge, this is the fi rst reported case of a SEA following E. coli PLA.

show abstract

The value of gadoxetic acid-enhanced MRI for differentiation between hepatic microabscesses and metastases in patients with periampullary cancer

Abstract: • Gadoxetic acid-enhanced MRI is useful for distinguishing hepatic microabscess from metastasis. • Hepatic microabscess showed significant size discrepancy ≥30% between T1WI and HBPI. • Arterial rim enhancement persistent through the TP indicates hepatic microabscess.

Cited by 18 publications

References 23 publications

Radiologic Evaluation and Structured Reporting Form for Extrahepatic Bile Duct Cancer: 2019 Consensus Recommendations from the Korean Society of Abdominal Radiology

Radiologic Evaluation and Structured Reporting Form for Extrahepatic Bile Duct Cancer: 2019 Consensus Recommendations from the Korean Society of Abdominal Radiology

Differentiating Between an Atypical Hepatic Abscess and Tumor Metastasis Using Magnetic Resonance Imaging and Hepatobiliary Phase Imaging

A unique case of metastatic spinal epidural abscess associated with liver abscess following ascending cholangitis and Escherichia coli bacteremia

Contact Info

Product

Resources

About