Hepatic parenchymal perfusion abnormalities after pancreaticobiliary surgery

1998 ◽  
Vol 39 (3) ◽  
pp. 304-308
Author(s):  
K. Mitsuzaki ◽  
Y. Yamashita ◽  
I. Ogata ◽  
T. Nishiharu ◽  
J. Urata ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Equilibrium Phase ◽  
Contrast Material ◽  
Helical Ct ◽  
Arterial Phase ◽  
Perfusion Abnormality ◽  
Portal Venous Phase ◽  
Before And After ◽  
Venous Phase ◽  
One Year

Purpose: To evaluate perfusion abnormalities of the liver after pancreaticobiliary surgery Material and Methods: We retrospectively evaluated 128 patients with pancreaticobiliary malignant tumors who had been examined both before and after surgery by means of helical CT of the liver. An infusion of 3 ml/s of 60% nonionic contrast material was followed by helical CT of the liver in a sequential arterial phase, portal venous phase, and equilibrium phase Results: of 128 patients, we followed 97. In 21 patients (22%) we found 47 lesions with perfusion abnormalities that were detected 1–33 months (mean 6.6 months) after the operation. All patients were asymptomatic. The shape of each perfusion abnormality was characterized as geographic (n=23, 47%), wedgeshaped (n=21, 45%), or round (n=3, 83.8%). The abnormalities were seen in the arterial phase in 46 lesions (98%), in the portal venous phase in 18 lesions (38%), and in the equilibrium phase in 1 lesion (0.2%). In all lesions, the size either decreased spontaneously, or it remained unchanged for more than one year Conclusion: Perfusion abnormalities of the liver may occur in patients who undergo pancreaticobiliary surgery. This findings should not be confused with hypervascular metastases

scholarly journals Regression of Hypervascular Nodules in a Patient with Wilson's Disease Awaiting Liver Transplantation

2009 ◽  
Vol 2009 ◽  
pp. 1-4
Author(s):  
Alcindo Pissaia ◽  
Hervé Gouya ◽  
Olivier Scatton ◽  
Filoména Conti ◽  
Yvon Calmus
Keyword(s):  
Liver Transplantation ◽  
Wilson’S Disease ◽  
Contrast Material ◽  
Wilson's Disease ◽  
Arterial Phase ◽  
Intravenous Contrast ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
One Year ◽  
Early Arterial Phase

This paper describes the regressive course over one year of hypervascular nodules in a patient with Wilson's disease. CT revealed multiple, enhancing nodules (up to 3 cm in diameter) detected in the liver in the early arterial phase after the administration of intravenous contrast material. Most of these nodules became isodense in the portal venous phase. After one year of efficient therapy combining d-penicillamine and zinc acetate, most of the nodules had disappeared, while the liver contours had become more regular. To our knowledge, the regression of large hypervascular nodules has not previously been reported in patients with Wilson's disease.

Case 5.6

2014 ◽  
pp. 253-253
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Equilibrium Phase ◽  
Arterial Phase ◽  
Recurrent Pancreatitis ◽  
Portal Venous Phase ◽  
History Of ◽  
Venous Phase ◽  
Delayed Phase

37-year-old woman with a history of recurrent pancreatitis and abdominal pain Arterial phase (Figure 5.6.1A), portal venous phase (Figure 5.6.1B), equilibrium phase (Figure 5.6.1C), and 8-minute delayed phase (Figure 5.6.1D) postgadolinium 3D SPGR images show multiple splenic lesions that are initially hypoenhancing relative to adjacent spleen and become hyperintense on delayed images....

Case 1.2

2014 ◽  
pp. 3-4
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Abdominal Pain ◽  
Signal Intensity ◽  
Equilibrium Phase ◽  
High Signal Intensity ◽  
Arterial Phase ◽  
High Signal ◽  
Portal Venous Phase ◽  
Hepatic Lobe ◽  
Venous Phase ◽  
The Right

66-year-old woman with nausea, vomiting, and abdominal pain after a recent fundoplication. Abdominal CT revealed a right hepatic lobe mass Coronal SSFSE (Figure 1.2.1) and axial fat-suppressed FSE T2-weighted (Figure 1.2.2) images demonstrate a lobulated mass with high signal intensity in the right hepatic lobe. Axial arterial phase, portal venous phase, and coronal oblique reformatted equilibrium phase postgadolinium 3D SPGR images (...

scholarly journals Hepatic parenchyma and vascular blood flow changes after TIPS with spectral CT iodine density in HBV-related liver cirrhosis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lei Wang ◽  
Rengui Wang ◽  
Chunyan Zhang ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Equilibrium Phase ◽  
Liver Parenchyma ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Hepatic Parenchyma ◽  
Before And After ◽  
Venous Phase ◽  
Flow Changes

AbstractTo compare changes in spectral CT iodine densities of hepatic parenchyma and vessels before and after transjugular intrahepatic portosystemic shunt (TIPS) in hepatitis B virus (HBV)-related liver cirrhosis. Twenty-five patients with HBV-related liver cirrhosis who received TIPS for gastroesophageal varices bleeding were recruited. Each patient underwent three phases contrast CT before and after TIPS within 4 weeks, with the raw data reconstructed at 1.25-mm-thick slices. Iodine density (in milligrams per milliliter) was measured on iodine-based material decomposition image. Multiple regions of interest (ROIs) in liver parenchyma, aorta and portal vein were selected from three slices of images. Portal vein trunk was set as the central one, and mean liver parenchymal iodine densities from arterial phase (AP), venous phase (VP) and equilibrium phase (EP) were recorded. Quantitative indices of iodine density (ID), including normalized ID in liver parenchyma for arterial phase (NIDLAP), ID of liver parenchyma for venous phase (IDLVP), ID of portal vein in venous phase (IDPVP) and liver arterial iodine density fraction (AIF), were measured and compared before and after TIPS. Based on Child–Pugh stage, 4, 12 and 9 patients were classified as grade A, B, and C, respectively. Liver volume was comparable before and after TIPS (1110.5 ± 287.4 vs. 1092.0 ± 276.3, P = 0.28). After TIPS, ID was decreased in aorta (146.0 ± 34.5 vs. 120.9 ± 30.7, P < 0.01) whereas increased in liver parenchyma at arterial phase, as demonstrated by IDAP (9.3 ± 3.1 vs. 13.4 ± 4.4 mg/mL) and AIF (0.40 ± 0.11 vs. 0.58 ± 0.11, P < 0.01). For venous or equilibrium phase, quantitative indices remained stable (23.1 ± 4.5 vs. 23.0 ± 5.3, 19.8 ± 4.1 vs. 19.4 ± 4.6) mg/mL (Ps > 0.05). For portal vein, ID and NID were increased after TIPS (23.1 ± 11.7 vs. 36.5 ± 13.0, 16.4 ± 8.5 vs. 31.8 ± 12.8) (P < 0.01). No positive correlation between iodine density and preoperative Child–Pugh score was observed. Based on iodine density measurement, spectral CT as a noninvasive imaging modality may assess hepatic parenchyma and vascular blood flow changes before and after TIPS in HBV-related liver cirrhosis.Clinical registration number: ChiCTR- DDC-16009986.

scholarly journals Changes in Spectral CT Iodine Densities before and after TIPS in HBV-related liver cirrhosis: A Preliminary Study

2021 ◽  
Author(s):  
Lei Wang ◽  
Rengui Wang ◽  
Chunyan Zhang ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Vein ◽  
Equilibrium Phase ◽  
Liver Parenchyma ◽  
Arterial Phase ◽  
Spectral Ct ◽  
Gastroesophageal Varices ◽  
Quantitative Indices ◽  
Before And After ◽  
Venous Phase

Abstract Objectives To compare changes in spectral CT iodine densities of hepatic parenchyma and vessels before and after transjugular intrahepatic portosystemic shunt (TIPS) in hepatitis B virus (HBV)-related liver cirrhosis. Materials and Methods Twenty-five patients with HBV-related liver cirrhosis who received TIPS for gastroesophageal varices bleeding were recruited. Each patient underwent three phases contrast CT before and after TIPS within 4 weeks, with the raw data reconstructed at 1.25-mm-thick slices. Iodine density (in milligrams per milliliter) was measured on iodine-based material decomposition image. Multiple regions of interest (ROIs) in liver parenchyma, aorta and portal vein were selected from three slices of images. Portal vein trunk was set as the central one, and mean liver parenchymal iodine densities from arterial phase (AP), venous phase (VP) and equilibrium phase (EP) were recorded. Quantitative indices of iodine density (ID), including normalized ID in liver parenchyma for arterial phase (NIDLAP), ID of liver parenchyma for venous phase (IDLVP), ID of portal vein in venous phase (IDPVP) and liver arterial iodine density fraction (AIF), were measured and compared before and after TIPS. Results Based on Child-Pugh stage, 4, 12 and 9 patients were classified as grade A, B, and C, respectively. Liver volume was comparable before and after TIPS (1110.5±287.4 vs. 1092.0±276.3, P = 0.28). After TIPS, ID was decreased in aorta (146.0±34.5 vs. 120.9± 30.7, P<0.01) whereas increased in liver parenchyma at arterial phase, as demonstrated by IDAP (9.3±3.1 vs. 13.4±4.4 mg/mL) and AIF (0.40±0.11 vs. 0.58 ± 0.11, P<0.01). For venous or equilibrium phase, quantitative indices remained stable (23.1±4.5 vs. 23.0±5.3, 19.8±4.1 vs. 19.4±4.6) mg/mL (Ps>0.05). For portal vein, ID and NID were increased after TIPS (23.1±11.7 vs. 36.5±13.0, 16.4±8.5 vs. 31.8±12.8) (P<0.01). No positive correlation between iodine density and preoperative Child-Pugh score was observed. Conclusions Based on iodine density measurement, spectral CT as a noninvasive imaging modality may assess hemodynamic changes before and after TIPS in HBV-related liver cirrhosis.

Acute-onset abdominal pain in a woman in her 30s

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 275-322 ◽  
Author(s):  
Rory O’Donohoe ◽  
Samantha Fitzsimmons ◽  
Timothy J C Bryant
Keyword(s):  
Abdominal Pain ◽  
Hepatocellular Adenoma ◽  
Sudden Onset ◽  
Acute Onset ◽  
Arterial Phase ◽  
List Type ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
Axial Ct ◽  
Multiphase Ct

Clinical introductionA woman in her 30s presented to the emergency department with sudden-onset abdominal pain with hypotension and tachycardia. She gave a history of congenital heart disease for which she had previously undergone multiple operations. On examination she demonstrated right upper quadrant tenderness. She underwent an urgent multiphase CT (figure 1A–C).Figure 1(A) Arterial phase coronal CT. (B) Arterial phase axial CT. (C) Portal venous phase axial CT.QuestionWhat is the underlying liver pathology?Hepatocellular adenomaCholangiocarcinomaHepatocellular carcinomaFocal nodular hyperplasiaHepatoblastoma

scholarly journals CT differentiation of gastric ectopic pancreas from gastric stromal tumors

2020 ◽  
Author(s):  
Jian Wang ◽  
Chang LIU ◽  
Fang Yang ◽  
Wenming Zhang ◽  
Weiqun Ao ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Ectopic Pancreas ◽  
Arterial Phase ◽  
Portal Venous Phase ◽  
Test Efficiency ◽  
Attenuation Value ◽  
Ct Attenuation ◽  
Venous Phase ◽  
Ct Attenuation Value ◽  
Ct Features

Abstract BackgroundGastric ectopic pancreas (GEPs) is a rare developmental anomaly which is difficult to differentiate it from submucosal tumor such as gastrointestinal stromal tumor (GIST) by imaging methods. So we retrospectively investigated the CT features of them to help us make the correct diagnosis.Materials and MethodsThis study enrolled 17 GEPs and 119 GSTs, which were proven pathologically. We assessed clinical and CT features to identify significant differential features of GEPs from GSTs using univariate and multivariate analyses.ResultsIn univariate analysis, among all clinicoradiologic features, features of age, symptom, tumor marker, location, contour, blurred serosa or fat-line of peritumor, necrosis, calcification, CT attenuation value of unenhancement phase/arterial phase/portal venous phase (CTu/CTa/CTp), the CT attenuation value of arterial phase/portal venous phase minus that of unenhanced phase (DEAP/DEPP), long diameter (LD), short diameter (SD) were considered statistically significant for the differentiation of them. And the multivariate analysis revealed that location, blurred serosa or fat-line of peritumor, necrosis and DEPP were independent factors affecting the identification of them.What's more, ROC analysis showed that the test efficiency of CTp was perfect(AUC= 0.900).ConclusionLocation, blurred serosa or fat-line of peritumor, necrosis and DEPP are useful CT differentiators of GEPs from GSTs. In addition, the test efficiency of CTp in differentiating them was perfect (AUC=0.900).

scholarly journals Advanced Deep Learning Approach to Automatically Segment Malignant Tumors and Ablation Zone in the Liver With Contrast-Enhanced CT

2021 ◽  
Vol 11 ◽  
Author(s):  
Kan He ◽  
Xiaoming Liu ◽  
Rahil Shahzad ◽  
Robert Reimer ◽  
Frank Thiele ◽  
...  
Keyword(s):  
Deep Learning ◽  
Liver Tumors ◽  
Treatment Success ◽  
Detection Sensitivity ◽  
Arterial Phase ◽  
Liver Segmentation ◽  
Portal Venous Phase ◽  
Venous Phase ◽  
Pre Treatment ◽  
Multi Phase

ObjectiveLiver cancer is one of the most commonly diagnosed cancer, and energy-based tumor ablation is a widely accepted treatment. Automatic and robust segmentation of liver tumors and ablation zones would facilitate the evaluation of treatment success. The purpose of this study was to develop and evaluate an automatic deep learning based method for (1) segmentation of liver and liver tumors in both arterial and portal venous phase for pre-treatment CT, and (2) segmentation of liver and ablation zones in both arterial and portal venous phase for after ablation treatment.Materials and Methods252 CT images from 63 patients undergoing liver tumor ablation at a large University Hospital were retrospectively included; each patient had pre-treatment and post-treatment multi-phase CT images. 3D voxel-wise manual segmentation of the liver, tumors and ablation region by the radiologist provided reference standard. Deep learning models for liver and lesion segmentation were initially trained on the public Liver Tumor Segmentation Challenge (LiTS) dataset to obtain base models. Then, transfer learning was applied to adapt the base models on the clinical training-set, to obtain tumor and ablation segmentation models both for arterial and portal venous phase images. For modeling, 2D residual-attention Unet (RA-Unet) was employed for liver segmentation and a multi-scale patch-based 3D RA-Unet for tumor and ablation segmentation.ResultsOn the independent test-set, the proposed method achieved a dice similarity coefficient (DSC) of 0.96 and 0.95 for liver segmentation on arterial and portal venous phase, respectively. For liver tumors, the model on arterial phase achieved detection sensitivity of 71%, DSC of 0.64, and on portal venous phase sensitivity of 82%, DSC of 0.73. For liver tumors &gt;0.5cm3 performance improved to sensitivity 79%, DSC 0.65 on arterial phase and, sensitivity 86%, DSC 0.72 on portal venous phase. For ablation zone, the model on arterial phase achieved detection sensitivity of 90%, DSC of 0.83, and on portal venous phase sensitivity of 90%, DSC of 0.89.ConclusionThe proposed deep learning approach can provide automated segmentation of liver tumors and ablation zones on multi-phase (arterial and portal venous) and multi-time-point (before and after treatment) CT enabling quantitative evaluation of treatment success.

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