scholarly journals Usefulness of contrast-enhanced ultrasound using perfluorobutanecontaining microbubbles as a planning for percutaneous biopsies of focal hepatic lesions: a prospective feasibility study

2019 ◽  
Vol 21 (2) ◽  
pp. 109 ◽  
Author(s):  
Sang Min Lee ◽  
Jung Hoon Kim ◽  
Hyun Kyung Yang ◽  
Hyo-Jin Kang ◽  
Joon Koo Han
Keyword(s):  
Target Lesion ◽  
Technical Failure ◽  
Mr Images ◽  
Point Scale ◽  
Focal Lesions ◽  
Technical Feasibility ◽  
Contrast Enhanced ◽  
Focal Hepatic Lesions ◽  
The Mean ◽  
Hepatic Lesions

Aims: To determine whether contrast-enhanced US using perfluorobutane-containing microbubbles (SEUS) would be helpful for planning a hepatic biopsy.Material and methods: This prospective study included 40 patients who planned to undergo hepatic biopsy for focal hepatic lesions. All patients underwent B-mode US followed by SEUS. The radiologist evaluated the number of detected lesions, presence of necrosis, conspicuity of target lesion and technical feasibility using 4-point scale. Technical failure and occurrence of change of the target were also assessed. Computer tomography (CT) or magnetic resonance (MR) images were the reference techniques. Results: The mean number of lesions detected on CT and MR images was 6.5±8.4. In 20 (50%) of 40 patients, more focal lesions were detected on SEUS. Targeted lesion was changed in sixpatients (15%) on SEUS. Mean number of detected lesions on SEUS was significantly higher comparing with B-US (5.1±6.2 vs. 2.8±3.8, p<0.001). Conspicuity of the targeted lesion was improved in 67.5% (27 of 40) on SEUS and significantly more visualized than B-US (3.6±0.8 vs. 2.8±0.9, p<0.001). In 7 more patients the necrosis within the lesion was visualized (17.5%) using SEUS. The technical feasibility on SEUS was significantly higher than B-US (2.3±1.0 vs. 3.3±0.9, p<0.001). Technical failure was observed in only one patient (2.5%).Conclusions: SEUS is a helpful technique for planning the hepatic biopsyin terms of detection, improving lesion conspicuity, tumor viable portion assessment and consequently higher operator confidence, compared with B-US.

Role of MRI in Detecting and Characterizing Small Hepatic Focal Lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rania Ali Maarouf ◽  
Ali Haggag Ali ◽  
Mahmoud Abdelatif Onsy
Keyword(s):  
Tumor Staging ◽  
Left Lobe ◽  
Diagnostic Process ◽  
Liver Imaging ◽  
Focal Lesions ◽  
Focal Hepatic Lesions ◽  
Malignant Lesions ◽  
Hepatic Lesions ◽  
The Right

Abstract Background Despite the recent advances in liver imaging, the detection and characterization of small hepatic focal lesions is still a real challenge. Particularly in cancer patients where the characterization of a small HFL as thus the precise tumor staging is critical for optimal treatment planning. Aim of the Work To explore the effectiveness, and hence the clinical utility, of MRI detection and characterization of small focal hepatic lesions either only discovered on MRI or as a further work up of CT/US-indeterminate lesions. Patients and Methods We reviewed our database for individuals who underwent liver MR imaging between March 2018 and March 2019 for the evaluation of small hepatic lesions that were discovered for the first time or had been previously visualized on routinely performed CT and had been considered indeterminate. Results The present study included 44 patients of which 26 were males (59.1%) and 18 were females (40.9%). The age range of the study group was 19 to 77 years. The mean age for Malignant lesions was 51 years. The right lobe of liver was involved in 23 cases (52.3%), left lobe in 5 cases (11.4%) and both lobes in 16 cases (36.4%). There were 30 (68.18%) benign, 13 (29.54%) malignant lesions and 1 (2.3%) indeterminate, hemangiomas were predominant in benign lesions whereas hepatocellular carcinomas were predominant in malignant lesions. N'TRI could characterize 92% cases. Conclusion The diagnostic process of small hepatic focal lesions, either detection or characterization or both, continues to represent a challenge. Contrast-enhanced MR can accurately detect and characterize majority of small hepatic focal lesions.

scholarly journals SIUMB recommendations for focal pancreatic lesions

2020 ◽  
Vol 23 (4) ◽  
pp. 599-606
Author(s):  
Mirko D’Onofrio ◽  
◽  
Ilario de Sio ◽  
Paoletta Mirk ◽  
Gianpaolo Vidili ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Medical Doctors ◽  
Contrast Enhanced ◽  
Focal Hepatic Lesions ◽  
Practical Guidelines ◽  
Contrast Enhanced Ultrasonography ◽  
Hepatic Lesions

Abstract Contrast-enhanced ultrasonography (CEUS) is increasingly being performed in Italy and Europe, particularly in the field of hepato-gastroenterology. Initially, it was mainly carried out to characterize focal hepatic lesions, but, since then, numerous studies have demonstrated its efficacy in the differential diagnosis of focal pancreatic pathologies (D’Onofrio et al. in Expert Rev Med Devices 7(2):257–273, 2010; Vidili et al. in J Ultrasound 22(1):41–51, 2019). The purpose of this paper is to provide Italian Medical Doctors with recommendations and thereby practical guidelines on the management of these patients. The present paper reports the final conclusions reached by the SIUMB guideline commission. This paper addresses particularly percutaneous ultrasound (US) examination (transabdominal US) and is drawn up specifically for publication.

Characterisation of small hypoattenuating hepatic lesions in multi-detector CT (MDCT) in patients with underlying extrahepatic malignancy: added value of contrast-enhanced MR images

2010 ◽  
Vol 20 (12) ◽  
pp. 2853-2861 ◽  
Author(s):  
Song-Ee Baek ◽  
Mi-Suk Park ◽  
Hye Sook Hong ◽  
Jin Young Choi ◽  
Yong Eun Chung ◽  
...  
Keyword(s):  
Added Value ◽  
Mr Images ◽  
Contrast Enhanced ◽  
Hepatic Lesions

scholarly journals Added Value of Contrast-Enhanced Ultrasound on Biopsies of Focal Hepatic Lesions Invisible on Fusion Imaging Guidance

2017 ◽  
Vol 18 (1) ◽  
pp. 152 ◽  
Author(s):  
Tae Wook Kang ◽  
Min Woo Lee ◽  
Kyoung Doo Song ◽  
Mimi Kim ◽  
Seung Soo Kim ◽  
...  
Keyword(s):  
Fusion Imaging ◽  
Added Value ◽  
Contrast Enhanced Ultrasound ◽  
Imaging Guidance ◽  
Contrast Enhanced ◽  
Focal Hepatic Lesions ◽  
Hepatic Lesions

Ascitic Fluid Cytokines in Chronic Liver Disease: A Possible Prognostic Tool

2021 ◽  
Author(s):  
Shimaa atta ◽  
Manal Kamel ◽  
Wafaa Mansour ◽  
Taghreed Hussein ◽  
Kesmat Maher ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Ascitic Fluid ◽  
Serum Levels ◽  
Malignant Ascites ◽  
Focal Lesions ◽  
Prognostic Tool ◽  
Significant Difference ◽  
Focal Hepatic Lesions ◽  
Hepatic Lesions ◽  
Fluid Levels

Introduction: Malignant ascites results from imbalance between protein in the peritoneal cavity and absorption of fluids via the lymphatic system. More than twenty interleukins are known to play an important role in the protection against tumors. Materials and methods: Ascitic fluid IL1B, IL2, IL4, IL6, IL10, TNFα, and IFNγ levels were assessed in forty-five patients with liver cirrhosis and ascites as judged by histopathological and ultra-sonographic findings. They were divided into two groups according to presence of hepatic focal lesions. Ten patients with focal hepatic lesions were randomly selected and subjected to analysis of serum levels of IL2 and IL10. Results: Ascitic fluid IL-4, IL-6 and IL-10 levels were found to be significantly higher in patients with hepatocellular carcinoma than patients with cirrhosis. TNFα, and IFNγ were also found to be higher in hepatocellular carcinoma than patients with cirrhosis but with no significance. On the other hand, there was no significant difference in levels of IL1B and IL2 between the two groups. Ascitic fluid IL2 and IL10 levels were found to be higher in ascitic fluid than in serum of the same patients. Conclusion: Ascitic fluid levels of IL-4, IL-6 and IL-10 are higher in hepatocellular carcinoma patients than patients with cirrhosis alone. Levels of ascitic fluid IL2 and IL10 were proved to be a better prognostic tool than their levels in sera of the same patients. To conclude; patients with cirrhosis may be subjected to schedualed examination of ascitic fluid cytokine to predect transformation into hepatocellular carcinoma.

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