scholarly journals Spectrum of Fontan-associated liver disease assessed by MRI and US in young adolescents

2021 ◽  
Author(s):  
Karl Julius Thrane ◽  
Lil Sofie Ording Müller ◽  
Kathrine Rydén Suther ◽  
Kristian Stien Thomassen ◽  
Henrik Holmström ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fontan Circulation ◽  
Imaging Findings ◽  
Portal Venous Phase ◽  
National Cohort ◽  
Hepatic Imaging ◽  
Venous Phase ◽  
Magnetic Resonance Imaging Mri ◽  
Serological Data ◽  
Imaging Signs

Abstract Purpose Patients with Fontan circulation are at risk of developing hepatic fibrosis/cirrhosis. The mechanisms and disease development are unclear and early secondary liver cancer is a concern. This study will describe hepatic imaging findings in a national cohort of adolescents with Fontan circulation. Methods The patients prospectively underwent abdominal contrast enhanced magnetic resonance imaging (MRI) including diffusion-weighted imaging. Images were assessed for criteria of fibrosis/cirrhosis including characterization of hepatic nodules. These nodules were in addition, assessed by ultrasonography (US). Nodules ≥ 1 cm were investigated and monitored to evaluate malignant transformation. Clinical and hepatic serological data were recorded. Results Forty-six patients, median age of 16.5 years (15.4–17.9 years) were enrolled. All patients underwent US examination and MRI was performed in 35/46 patients. On MRI, 60% had hepatomegaly and 37% had signs of fibrosis/cirrhosis. Seven patients had together 13 nodules ≥ 1 cm in diameter. Only 4/13 (17%) where seen on US. Nodules had variable MRI signal characteristics including hepatobiliary contrast enhancement and two nodules revealed portal venous phase ‘wash-out’ on the first examination. No further imaging signs of malignancy were revealed during the follow-up period of median 24.4 (7–42) months. Conclusion The majority of adolescents with Fontan circulation had imaging findings of fibrosis/cirrhosis of varying severity. US had low detection rate of hepatic nodules compared to MRI. The imaging work-up before transition to adult cardiology care did not reveal findings suggestive of malignancy. However, the high prevalence of Fontan-associated liver disease calls for surveillance strategies even in childhood.

Case 2.23

2014 ◽  
pp. 107-107
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Liver Disease ◽  
Signal Intensity ◽  
Phase Image ◽  
Hepatobiliary Phase ◽  
Portal Venous Phase ◽  
Hepatic Lobe ◽  
Phase Images ◽  
Venous Phase ◽  
The Right ◽  
Multiple Nodules

55-year-old woman with chronic liver disease Axial fat-suppressed FSE T2-weighted images (Figure 2.23.1) demonstrate a cirrhotic liver with diffuse, innumerable, small low-signal-intensity nodules. Axial arterial, portal venous, and hepatobiliary phase postgadolinium (Eovist) 3D SPGR images (Figure 2.23.2) demonstrate heterogeneous enhancement of the background parenchyma, particularly in the right hepatic lobe. The multiple nodules are initially hypointense on arterial and portal venous phase images but become hyperintense relative to adjacent liver on the hepatobiliary phase image....

scholarly journals Clinical Importance of Incidentally Detected Hyperenhancing Liver Observations on Portal Venous Phase Computed Tomography in Patients Without Known Malignancy or Liver Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael T. Corwin ◽  
Ryan T. DiGeronimo ◽  
Shannon M. Navarro ◽  
Ghaneh Fananapazir ◽  
Machelle Wilson ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Liver Disease ◽  
Clinical Importance ◽  
Portal Venous Phase ◽  
Venous Phase

scholarly journals Mass-forming cholangiocarcinoma

2019 ◽  
Vol 2 (1) ◽  
pp. 15-17
Author(s):  
Tanita Suttichaimongkol ◽  
Kawin Tangvoraphonkchai ◽  
Arin Pisanuwongse
Keyword(s):  
Diagnostic Tools ◽  
Arterial Phase ◽  
Case Presentation ◽  
Intraductal Growth ◽  
Portal Venous Phase ◽  
Contrast Enhanced ◽  
Liver Cancers ◽  
Contrast Magnetic Resonance ◽  
Venous Phase ◽  
Magnetic Resonance Imaging Mri

Cholangiocarcinoma is the second most common primary liver cancers. It is arising from epithelial cells of the biliary tract. It has been categorized to intrahepatic and extrahepatic. The Intrahepatic orperipheral cholangiocarcinoma can be presented as mass-forming, periductal infiltrating and intraductal growth. Many patients of mass-forming cholangiocarcinoma have symptoms such as abdominal pain about 85% but some patients don’t have any symptoms. This is the difficult cancer to diagnose. While patients were having any symptom, the disease was an advanced stage (unresectable). The diagnostic tools for assess this disease are imaging modalities include ultrasound (US), computed tomography (CT) with contrast, magnetic resonance imaging (MRI) with contrast. However, the goal standard for confirm diagnosis is tissue pathology. This article showed a case presentation and reviewed the imaging appearance of mass-forming cholangiocarcinoma.   Figure 1  Axial non-contrast (A), axial contrast enhanced in arterial phase (B), axial contrast enhanced in portal venous phase (C) and axial contrast enhanced in 5-minute delay phase (D) CT scans show a large ill-defined hypodense mass at hepatic segment 7/8, about 7.0x7.0x5.0 cm in APxLxH diameter, which has poor enhancement on arterial phase with gradual progressive enhancement on portal venous and 5-minute delay phase. Coronal contrast enhanced in portal venous phase CT scan (E) shows mass confined in peripheral area of right hepatic lobe with hepatic vein abutment.

scholarly journals The Feature of Solitary Small Nodular Type of Hepatic Epithelioid Hemangioendothelioma

2018 ◽  
Vol 12 (2) ◽  
pp. 402-410
Author(s):  
Norio Kubo ◽  
Norifumi Harimoto ◽  
Kenichiro Araki ◽  
Kei Hagiwara ◽  
Takahiro Yamanaka ◽  
...  
Keyword(s):  
Late Phase ◽  
Epithelioid Hemangioendothelioma ◽  
Arterial Phase ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
Segment Viii ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Specific Symptoms

Hepatic epithelioid hemangioendothelioma (HEHE) is a rare tumor. Preoperative diagnosis of HEHE is difficult because it does not manifest specific symptoms or tumor markers. We report a resected case of small and solitary HEHE. The patient, a 74-year-old man, had undergone surgical resection for left renal cell carcinoma 20 years ago. During follow-up, a tumor approximately 1.3 cm in diameter was detected by computed tomography (CT) at liver segment VIII. It showed isodensity in the arterial phase, low density in the portal venous phase, and homogeneous enhancement in the late phase on CT and magnetic resonance imaging (MRI). We performed hepatic resection of the right hepatic vein drainage area. A pathological diagnosis of HEHE was made. Although small and solitary HEHE is rare, an enhancement pattern in each phase on CT and MRI, using contrast media, can yield clues for the diagnosis of HEHE.

Case 2.31

2014 ◽  
pp. 119-120
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Cirrhotic Liver ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
P 53

53-year-old woman with chronic liver disease Axial fat-suppressed 2D SSFP images (Figure 2.31.1) demonstrate a nodular cirrhotic liver with splenomegaly and enlarged patent umbilical veins. Subvolume MIP (Figure 2.31.2) and VR (Figure 2.31.3) images reconstructed from a portal venous phase postgadolinium 3D SPGR acquisition again demonstrate large paraumbilical varices....

Hepatic imaging response to 90y-microsphere therapy administered for tumor progression during systemic chemotherapy in patients with colorectal liver metastases.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 270-270 ◽  
Author(s):  
Andrew S. Kennedy ◽  
David Ball ◽  
Steven J. Cohen ◽  
Michael Cohn ◽  
Douglas M. Coldwell ◽  
...  
Keyword(s):  
Tumor Progression ◽  
Systemic Chemotherapy ◽  
Background Characteristics ◽  
Portal Venous Phase ◽  
Common Mean ◽  
Kaplan Meier ◽  
Hepatic Imaging ◽  
Radiological Response ◽  
Venous Phase ◽  
Imaging Response

270 Background: Hepatic tumor progression after one or more lines of 5FU-based systemic chemotherapy, with or without biologic agents, is an indication for radioembolization using 90Y microspheres. Methods: An independent imaging review following resin-only 90Y microsphere treated cases of mCRC from July 2002 to December 2011 at 9 US institutions was conducted. A board certified radiologist systematically reviewed hepatic Computed Tomography (CT) images (portal-venous phase) at baseline and 3 months after 90Y treatment. Tumor response was assessed using RECIST 1.0 criteria, based on a maximum of 5 target lesions. Peri-tumoral edema and necrosis; known artifacts which can affect the interpretation of RECIST response, were documented for each lesion. Kaplan Meier analysis compared survival for responders [Partial Response (PR)] vs. non-responders [Stable Disease (SD) or Progressive Disease (PD)]. Results: A total of 184 patients were studied; male (61%) and Caucasians (61%) most common, mean age 62.5 years received a median of 2 (range 1–5) lines of chemotherapy prior to 90Y therapy. Median tumor/liver ratio at 90Y therapy was 15% (IQR 20%). Median 90Y activity administered was 1.18 GBq (IQR 0.55). RECIST response at 3 months was 9.8% PR (n=18), 72.3% SD (133) and 17.9% PD (33); Disease Control Rate = 82.1%. Peri-tumoral edema was documented in 33% (n=60); necrosis in 42% (79); both in 22% (40) of cases, respectively. No significant differences in background characteristics between responders and non-responders were evident (p>0.05). RECIST response at 3 months predicted survival: PR median 13.9 months (95% CI 9.2-30.3) vs. SD 11.0 (8.9-13.5) vs. PD 6.7 (5.5-8.1) [p=0.002]. Conclusions: Radiological lesion response to 90Y therapy at 3 months must be interpreted with caution due to the significant proportions of peri-tumoral edema and necrosis encountered. Both of these artifacts may lead to either the under estimation of PR/SD or the overestimation of PD, respectively. Given these caveats, early (3 month) hepatic radiological response to 90Y therapy appears to predict longer term prognosis.

scholarly journals Serial magnetic resonance imaging findings during severe attacks of familial hemiplegic migraine type 2: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Fear ◽  
Misha Patel ◽  
Ramin Zand
Keyword(s):  
Magnetic Resonance Imaging ◽  
Family History ◽  
Magnetic Resonance ◽  
Familial Hemiplegic Migraine ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Hemiplegic Migraine ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Changes

Abstract Background Hemiplegic migraines represent a heterogeneous disorder with various presentations. Hemiplegic migraines are classified as sporadic or familial based on the presence of family history, but both subtypes have an underlying genetic etiology. Mutations in the ATP1A2 gene are responsible for Familial Hemiplegic type 2 (FHM2) or the sporadic hemiplegic migraine (SHM) counterpart if there is no family history of the disorder. Manifestations include migraine with aura and hemiparesis along with a variety of other symptoms likely dependent upon the specific mutation(s) present. Case presentation We report the case of an adult man who presented with headache, aphasia, and right-sided weakness. Workup for stroke and various infectious agents was unremarkable during the patient’s extended hospital stay. We emphasize the changes in the Magnetic Resonance Imaging (MRI) over time and the delay from onset of symptoms to MRI changes in Isotropic Diffusion Map (commonly referred to as Diffusion Weighted Imaging (DWI)) as well as Apparent Diffusion Coefficient (ADC). Conclusions We provide a brief review of imaging findings correlated with signs/symptoms and specific mutations in the ATP1A2 gene reported in the literature. Description of the various mutations and consequential presentations may assist neurologists in identifying cases of Hemiplegic Migraine, which may include transient changes in ADC and DWI imaging throughout the course of an attack.

scholarly journals Many faces of acute bowel ischemia: overview of radiologic staging

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Amir H. Davarpanah ◽  
Afshar Ghamari Khameneh ◽  
Bardia Khosravi ◽  
Ali Mir ◽  
Hiva Saffar ◽  
...  
Keyword(s):  
Wide Spectrum ◽  
Bowel Ischemia ◽  
Management Approach ◽  
Final Decision ◽  
Imaging Findings ◽  
Life Threatening ◽  
Imaging Signs ◽  
Late Stages ◽  
Underlying Pathophysiology ◽  
Made In

AbstractAcute bowel ischemia (ABI) can be life threatening with high mortality rate. In spite of the advances made in diagnosis and treatment of ABI, no significant change has occurred in the mortality over the past decade. ABI is potentially reversible with prompt diagnosis. The radiologist plays a central role in the initial diagnosis and preventing progression to irreversible intestinal ischemic injury or bowel necrosis. The most single imaging findings described in the literature are either non-specific or only present in the late stages of ABI, urging the use of a constellation of features to reach a more confident diagnosis. While ABI has been traditionally categorized based on the etiology with a wide spectrum of imaging findings overlapped with each other, the final decision for patient’s management is usually made on the stage of the ABI with respect to the underlying pathophysiology. In this review, we first discuss the pathologic stages of ischemia and then summarize the various imaging signs and causes of ABI. We also emphasize on the correlation of imaging findings and pathological staging of the disease. Finally, a management approach is proposed using combined clinical and radiological findings to determine whether the patient may benefit from surgery or not.

scholarly journals Value of contrast-enhanced CT texture analysis in predicting IDH mutation status of intrahepatic cholangiocarcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Zhu ◽  
Yingfan Mao ◽  
Jun Chen ◽  
Yudong Qiu ◽  
Yue Guan ◽  
...  
Keyword(s):  
Texture Analysis ◽  
Ct Images ◽  
Textural Features ◽  
Mutation Status ◽  
Portal Venous Phase ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Venous Phase ◽  
Ct Texture Analysis

AbstractTo explore the value of contrast-enhanced CT texture analysis in predicting isocitrate dehydrogenase (IDH) mutation status of intrahepatic cholangiocarcinomas (ICCs). Institutional review board approved this study. Contrast-enhanced CT images of 138 ICC patients (21 with IDH mutation and 117 without IDH mutation) were retrospectively reviewed. Texture analysis was performed for each lesion and compared between ICCs with and without IDH mutation. All textural features in each phase and combinations of textural features (p < 0.05) by Mann–Whitney U tests were separately used to train multiple support vector machine (SVM) classifiers. The classification generalizability and performance were evaluated using a tenfold cross-validation scheme. Among plain, arterial phase (AP), portal venous phase (VP), equilibrium phase (EP) and Sig classifiers, VP classifier showed the highest accuracy of 0.863 (sensitivity, 0.727; specificity, 0.885), with a mean area under the receiver operating characteristic curve of 0.813 in predicting IDH mutation in validation cohort. Texture features of CT images in portal venous phase could predict IDH mutation status of ICCs with SVM classifier preoperatively.

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