Helical CT for Detecting Focal Liver Lesions in Patients with Breast Carcinoma: Comparison of Noncontrast Phase, Hepatic Arterial Phase, and Portal Venous Phase

1997 ◽  
Vol 21 (2) ◽  
pp. 229-235 ◽  
Author(s):  
M. Gena Frederick ◽  
Erik K. Paulson ◽  
Rendon C. Nelson
Keyword(s):  
Breast Carcinoma ◽  
Helical Ct ◽  
Arterial Phase ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Portal Venous Phase ◽  
Hepatic Arterial Phase ◽  
Venous Phase

scholarly journals Imaging features of hepatocellular carcinoma with bile duct tumor thrombus：a multicenter study

2020 ◽  
Author(s):  
Li-Ming Huang ◽  
Jun-Yi Wu ◽  
Yan-Nan Bai ◽  
Jia-Yi Wu ◽  
Yong-Gang Wei ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Ct Scans ◽  
Arterial Phase ◽  
Imaging Features ◽  
Portal Venous Phase ◽  
Bile Duct Tumor ◽  
Hepatic Arterial Phase ◽  
Mri Scans ◽  
Venous Phase

Abstract Background: There are still difficult and challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1-B3 BDTT. Methods: The clinicopathological data and imaging findings of 30 HCC patients with B1-B3 BDTT from three high-volume institutions were retrospectively reviewed. Eighteen patients underwent computed tomography (CT) scans and twelve patients underwent magnetic resonance imaging (MRI) scans before operation, respectively. The diagnosis of HCC with BDTT was confirmed by postoperative pathologic examination.Results: According to Japanese classification, 5 patients were classified as B1 BDTT, 12 B2, 13 B3, and 82 B4, respectively. The HCC lesions were detected in all patients, and the localized bile duct dilation were detected in 28 (93.3%) patients. The BDTT was observed in all B3 patients and 3 B2 patients, but it was not observed in all B1 patients on CT or MRI. The BDTT showed relatively hypoattenuation on plain CT scans and T1W images, relatively hyperattenuation signals on T2W. The BDTT showed hyperattenuation at hepatic arterial phase with washout at portal venous phase. The localized biliary dilation showed no enhancement at hepatic arterial phase and no progressively delayed enhancement at portal venous phase, but it was more obvious at portal venous phase on CT.Conclusions: The HCC lesions and the localized bile duct dilatation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis for B1-B3 BDTT.

scholarly journals Value of Contrast-Enhanced Ultrasound in Differential Diagnosis of Focal Liver Lesions

2017 ◽  
pp. 36-52
Author(s):  
E. I. Peniaeva ◽  
J. R. Kamalov ◽  
A. N. Sencha ◽  
U. N. Patrunov ◽  
E. A. Sencha
Keyword(s):  
Differential Diagnosis ◽  
Contrast Enhancement ◽  
Complex Analysis ◽  
Final Diagnosis ◽  
Arterial Phase ◽  
Focal Liver Lesions ◽  
Diagnostic Feature ◽  
Liver Lesions ◽  
Contrast Enhanced ◽  
Venous Phase

Purpose:to evaluate the diagnostic value of contrastenhanced ultrasound (CEUS) with SonoVue in differential diagnosis of focal liver lesions (FLL) in a multidisciplinary clinic in Russian Federation.Materials and methods. Bolus intravenous administration of 1.2 ml of SonoVue (Bracco Swiss CA, Switzerland) followed with 5ml saline flush was used for liver CEUS. We utilized the scanners Mindray DC-8 (Mindrаy, China), Logiq S8 (GE, USA), Philips Epiq 7 (Philips, Holland), SonoScape S9 (SonoScape, China), Hitachi Ascendus (Hitachi, Japan) with 3.0–5.0 MHz convex probes in specialized “contrast” mode with low mechanic index (MI 0.08–0.1). The study conferred 73 patients in the age between 18 and 84 years (mean age 49 years) with FLL. CEUS was performed in 22 patients with previously verified diagnosis, while the rest of patients underwent CEUS before the final diagnosis. Contrast-enhanced liver CT was performed in all patients. In 49 (67.12%) of 73 cases, a pathology was performed after a targeted core-needle biopsy or autopsy. Qualitative features of US contrast enhancement of FLL were evaluated.Results. Qualitative aspects of CEUS for differentiation of FLL were defined. The principal sign for diagnosis between benign and malignant masses with CEUS was hypoenhancement of malignant lesions in comparison to surrounding normal parenchyma in portal and late venous phase (p ≤ 0.01). Alternatively, hyper- or isoenhancement throughout late venous phase was characteristic for benign FLL. Diffuse heterogeneous contrast enhancement was indicative of malignant FLL, and homogeneous – for benign. Additional diagnostic feature (p ≤ 0.05) was the type of contrast enhancement in the arterial phase. Heterogeneous diffuse contrast enhancement was observed in malignant FLL, while homogeneous – in benign FLL. Peripheral nodular contrast enhancement with centripetal filling was characteristic for liver hemangioma, centrifugal filling with “spoke-wheel” vascular pattern – for FNH, and peripheral rim-like hyperenhancement with rapid achievement of hypoenhancement at the beginning of the portal phase – for liver metastasis.Conclusion.Complex analysis of qualitative characteristics of CEUS with SonoVue is a promising option for differential diagnosis of FLL (sensitivity 92.85%, specificity 91.3%, diagnostic accuracy 92.15%) and can be utilized in daily practice.

scholarly journals Imaging Features of Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Multicenter Study

2020 ◽  
Author(s):  
Li-Ming Huang ◽  
Jun-Yi Wu ◽  
Yan-Nan Bai ◽  
Jia-Yi Wu ◽  
Yong-Gang Wei ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Tumor Thrombus ◽  
Ct Scans ◽  
Arterial Phase ◽  
Imaging Features ◽  
Portal Venous Phase ◽  
Hepatic Arterial Phase ◽  
Mri Scans ◽  
Venous Phase

Abstract Background: There are still difficult and challenging problems in diagnosis of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) before operation. This study aimed to analyze the imaging features of HCC with B1-B3 BDTT. Methods: The clinicopathological data and imaging findings of 30 HCC patients with B1-B3 BDTT from three high-volume institutions were retrospectively reviewed. Eighteen patients underwent computed tomography (CT) scans and twelve patients underwent magnetic resonance imaging (MRI) scans before operation, respectively. The diagnosis of HCC with BDTT was confirmed by postoperative pathologic examination.Results: According to Japanese classification, 5 patients were classified as B1 BDTT, 12 B2, 13 B3, and 82 B4, respectively. The HCC lesions were detected in all patients, and the localized bile duct dilation were detected in 28 (93.3%) patients. The BDTT was observed in all B3 patients and 3 B2 patients, but it was not observed in all B1 patients on CT or MRI. The BDTT showed relatively hypoattenuation on plain CT scans and T1W images, relatively hyperattenuation signals on T2W. The BDTT showed hyperattenuation at hepatic arterial phase with washout at portal venous phase. The localized biliary dilation showed no enhancement at hepatic arterial phase and no progressively delayed enhancement at portal venous phase, but it was more obvious at portal venous phase on CT.Conclusions: The HCC lesions and the localized bile duct dilatation on CT or MRI scans are imaging features of HCC with BDTT, which might facilitate the early diagnosis for B1-B3 BDTT.

ROLE OF MULTIPHASE STUDY OF LIVER LESIONS ON 128 SLICE DUAL SOURCE COMPUTED TOMOGRAPHY (CT) WITH CYTOLOGY OR HISTOPATHOLOGICAL CORRELATION

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Nisma Waheed ◽  
Rajneesh Madhok ◽  
Ashish Kumar Gupta ◽  
Tanu Agarwal
Keyword(s):  
Computed Tomography ◽  
Radiology Department ◽  
Arterial Phase ◽  
Liver Lesions ◽  
Common Pattern ◽  
Portal Venous Phase ◽  
Histopathological Correlation ◽  
Dual Source ◽  
Venous Phase ◽  
Delayed Scan

Introduction: Dual source Multidetector Computed Tomography (MDCT) provides multiphase study of various liver lesions for better detection and characterization. This study aims to detect and characterize the liver lesions in multiphase Computed Tomography (CT) with cytological and histopathological correlation to confirm the diagnosis. Material and Methods: This cross-sectional study included 65 patients who were referred to the Radiology Department of Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India with clinical features jaundice, pain in abdomen, nausea and vomiting. All patients were evaluated by five phase CT (unenhanced, early and late arterial, portal venous and delayed scan) of liver with Siemens128 slice dual source spiral CT. Protocols with a scan delay of 06 seconds, 09 seconds, 45 seconds and 180-300 seconds from contrast bolus was preselected for early and late arterial, portovenous and delayed scans. Results: Sixty five (age 10yrs- 90yrs) patients were included in the study. Most common neoplasm was metastases 33(51%). Hepatocellular carcinoma (HCC) were 18(28%), hemangioma 10(15%), peripheral intrahepatic cholangiocarcinoma 1 and 3 were non-neoplastic which included hepatic abscesses and hydatid cyst. Most common pattern of enhancement of metastasis in arterial phase was hypodense with peripheral enhancement and most were hypodense in portal venous phase. Portal venous phase had highest grade for hypovascular metastases and arterial phase had high grade to detect hypervascular metastasis. Delayed scan was better for smaller lesions less than 1cm. The sensitivity to detect metastases was 94%. Most common pattern of enhancement in HCC (variegated or heterogeneous enhancement in arterial phase with rapid washout in the portal venous phase. Total sensitivity to detect HCC was 83.3%. Hemangioma showed peripheral globular enhancement in arterial phase. In portal venous and delayed phase showed progressive enhancement with more centripetal filling. Sensitivity was 90% in case of hemangiomas. Conclusion: Multiphasic CT scan is a good non-invasive tool and can be used as first line imaging modality for differentiating benign and malignant liver lesions.

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 Hepatocellular carcinoma in a case of hepatitis C

2017 ◽  
Vol 5 (8) ◽  
pp. 3748
Author(s):  
Pokhraj P. Suthar ◽  
Gaurav R. Parmar ◽  
Chinmay Trivedi ◽  
Hemen I. Vithlani
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Arterial Phase ◽  
Oesophageal Varices ◽  
Abnormal Liver Function Test ◽  
Hcv Rna ◽  
Portal Venous Phase ◽  
Hepatic Arterial Phase ◽  
Liver Cancers ◽  
Venous Phase

Hepatocellular carcinoma has incidence of 90% of all liver cancers. HCC is the second most common hepatic malignancy in children after the hepatoblastomas. Patients with hepatocellular carcinoma presents with symptoms like pruritus, splenomegaly, bleeding oesophageal varices etc. Computed Tomography of the liver can look for local spread and thorax can look for metastases. Our case was a 49-year- old hepatitis C positive female came with vague right upper quadrant abdominal discomfort with weight loss of 7 lbs in last 2 months. Mild icterus was present on examination. CT scan revealed a well-defined iso-dense lesion in the segment V of right lobe of the liver, which shows enhancement in the hepatic arterial phase and rapid washout in the portal venous phase. Laboratory investigations showed abnormal liver function test. The HCV RNA levels were 1.45×105 IU/ml by real time PCR. Histopathology examination of biopsy specimen shows characteristic morphological features of steatohepatitic variant of hepatocellular carcinoma. Then the patient was referred to the higher center for the further management.

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

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....

Tips and Tricks in Contrast-Enhanced Ultrasound (CEUS) for the Characterization and Detection of Liver Malignancies

2019 ◽  
Vol 40 (04) ◽  
pp. 404-424 ◽  
Author(s):  
Barbara Schellhaas ◽  
Deike Strobel
Keyword(s):  
Liver Cirrhosis ◽  
Contrast Enhancement ◽  
Late Phase ◽  
Therapeutic Monitoring ◽  
Arterial Phase ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Liver Malignancies ◽  
Contrast Enhanced

AbstractContrast-enhanced ultrasound (CEUS) has a high diagnostic accuracy in the assessment of focal liver lesions. Clinical context (presence of liver cirrhosis, history of other malignancy versus incidental finding) is crucial for the correct interpretation of CEUS findings. CEUS has to be preceded by structured anamnesis and clinical examination as well as accurate B-mode sonography. Metastases are the most common malignant liver lesions in a non-cirrhotic liver. According to their contrast enhancement in the arterial phase, metastases are categorized as hyper- and hypo-vascular metastases. A common feature of all metastatic lesions is washout of the contrast agent in the portal venous or late phase. In the context of liver cirrhosis, > 95 % of focal liver lesions are hepatocellular carcinomas (HCCs). HCCs typically show arterial phase hyperenhancement, followed by mild and gradual contrast washout occurring very late in the late phase. For intrahepatic cholangiocellular carcinoma (ICC), the pattern of contrast enhancement in the arterial phase can vary. However, all ICCs typically show early and pronounced washout. Other liver malignancies like lymphoma, angiosarcoma, epithelioid hemangioendothelioma and others are very rare. Except for the contrast washout seen in all liver malignancies, they do not display pathognomonic enhancement patterns upon CEUS. Thus, biopsy is indispensable for definite diagnosis of the tumor entity. Furthermore, CEUS is used for the detection of metastases and therapeutic monitoring after local ablative procedures. The examination procedure differs slightly depending on the specific indication (characterization, detection).

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