scholarly journals Assessment of the follow-up interval changes of the less than 2 cm arterial phase enhancing hepatic nodules in correlation with Liver Imaging Reporting and Data System (LI-RADS) classification version 18 using contrast-enhanced multidetector computed tomography

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Sayed M. Mehana
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Data System ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Contrast Enhanced

scholarly journals Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2350
Author(s):  
Puran . ◽  
Narendra Kumar Kardam
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Abdominal Trauma ◽  
Imaging Modality ◽  
Abdominal Injury ◽  
Male Predominance ◽  
Ct Findings ◽  
Highly Sensitive

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed   tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.

scholarly journals Noninvasive Diagnosis of Hepatocellular Carcinoma on Sonazoid-Enhanced US: Value of the Kupffer Phase

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 141
Author(s):  
Hiroshi Takahashi ◽  
Katsutoshi Sugimoto ◽  
Naohisa Kamiyama ◽  
Kentaro Sakamaki ◽  
Tatsuya Kakegawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Performance ◽  
Late Phase ◽  
Imaging Feature ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Noninvasive Diagnosis ◽  
Contrast Enhanced ◽  
Treatment Naïve ◽  
Hepatic Lesions

The aim of this study was to compare the diagnostic performance of Contrast-Enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS) version 2017, which includes portal- and late-phase washout as a major imaging feature, with that of modified CEUS LI-RADS, which includes Kupffer-phase findings as a major imaging feature. Participants at risk of hepatocellular carcinoma (HCC) with treatment-naïve hepatic lesions (≥1 cm) were recruited and underwent Sonazoid-enhanced US. Arterial phase hyperenhancement (APHE), washout time, and echogenicity in the Kupffer phase were evaluated using both criteria. The diagnostic performance of both criteria was analyzed using the McNemar test. The evaluation was performed on 102 participants with 102 lesions (HCCs (n = 52), non-HCC malignancies (n = 36), and benign (n = 14)). Among 52 HCCs, non-rim APHE was observed in 92.3% (48 of 52). By 5 min, 73.1% (38 of 52) of HCCs showed mild washout, while by 10 min or in the Kupffer phase, 90.4% (47 of 52) of HCCs showed hypoenhancement. The sensitivity (67.3%; 35 of 52; 95% CI: 52.9%, 79.7%) of modified CEUS LI-RADS criteria was higher than that of CEUS LI-RADS criteria (51.9%; 27 of 52; 95% CI: 37.6%, 66.0%) (p = 0.0047). In conclusion, non-rim APHE with hypoenhancement in the Kupffer phase on Sonazoid-enhanced US is a feasible criterion for diagnosing HCC.

Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Diagnosing Hepatocellular Carcinoma: Diagnostic Performance and Interobserver Agreement

2020 ◽  
Author(s):  
Hang Zhou ◽  
Chao Zhang ◽  
Linyao Du ◽  
Jiapeng Jiang ◽  
Qing Zhao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Diagnostic Performance ◽  
Data System ◽  
Liver Imaging ◽  
Contrast Enhanced Ultrasound ◽  
High Risk Patients ◽  
Contrast Enhanced ◽  
Sensitivity Range ◽  
Risk Patients

Abstract Objectives To determine the diagnostic performance and inter-reader agreement of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. Methods In this prospective study, CEUS-LI-RADS categories (LR-5 for predicting HCC) were assigned by six blinded readers and compared to the definitive HCC diagnosis in patients with liver cirrhosis per the 2017 China Liver Cancer Guidelines (CLCG). CEUS features were recorded in 96 patients with 96 histology-proven lesions. The diagnostic performance of LR-5 was described by the sensitivity, specificity and accuracy. Multi-reader agreement was assessed by using intraclass correlation coefficients (ICC). Results In cirrhotic patients, the specificity of LR-5 (range: 92.7–100.0 %) was statistically higher than that of CLCG for each reader (range: 28.6–64.3 %). However, the sensitivity (range: 38.6–63.6 %) and accuracy (range: 53.4–70.7 %) were statistically lower in CEUS-LIRADS than in CLCG (sensitivity range: 88.6–100.0 %; accuracy range: 77.6–86.2 %). Only fair to moderate inter-reader agreement was achieved for the CEUS-LI-RADS category (ICC = 0.595) and washout appearance (ICC range: 0.338 to 0.555). Neither nodule-in-nodule nor mosaic architecture was observed more often in HCC (all P > 0.05), with poor inter-reader consistency for both (both ICC < 0.20). Conclusion CEUS-LI-RADS category 5 has a high specificity but a low accuracy for identifying HCC in high-risk patients. Inter-reader agreement is not satisfactory concerning CEUS-LIRADS category and washout appearance. Moreover, the clinical value of ancillary features favoring HCC is quite limited.

scholarly journals Usefulness of Modified CEUS LI-RADS for the Diagnosis of Hepatocellular Carcinoma Using Sonazoid

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 828
Author(s):  
Katsutoshi Sugimoto ◽  
Tatsuya Kakegawa ◽  
Hiroshi Takahashi ◽  
Yusuke Tomita ◽  
Masakazu Abe ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Adrenal Rest Tumor ◽  
Contrast Enhanced ◽  
Rim Enhancement ◽  
Diagnostic Usefulness ◽  
Adrenal Rest ◽  
Sensitivity Specificity

The Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) was introduced for classifying suspected hepatocellular carcinoma (HCC). However, it cannot be applied to Sonazoid. We assessed the diagnostic usefulness of a modified CEUS LI-RADS for HCC and non-HCC malignancies based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patients with chronic liver disease at risk for HCC were evaluated retrospectively. Nodules ≥1 cm with arterial phase hyperenhancement, no early washout (within 60 s), and contrast defects in the Kupffer phase were classified as LR-5. Nodules showing early washout, contrast defects in the Kupffer phase, and/or rim enhancement were classified as LR-M. A total of 104 nodules in 104 patients (median age: 70.0 years; interquartile range: 54.5–78.0 years; 74 men) were evaluated. The 48 (46.2%) LR-5 lesions included 45 HCCs, 2 high-flow hemangiomas, and 1 adrenal rest tumor. The PPV of LR-5 for HCC was 93.8% (95% confidence interval (CI): 82.8–98.7%). The 22 (21.2%) LR-M lesions included 16 non-HCC malignancies and 6 HCCs. The PPV of LR-M for non-HCC malignancies, including six intrahepatic cholangiocarcinomas, was 100% (95% CI: 69.8–100%). In conclusion, in the modified CEUS LI-RADS for Sonazoid, LR-5 and LR-M are good predictors of HCC and non-HCC malignancies, respectively.

Differentiation of intrapancreatic accessory spleen from small hypervascular neuroendocrine tumor of the pancreas: textural analysis on contrast-enhanced computed tomography

2018 ◽  
Vol 60 (5) ◽  
pp. 553-560 ◽  
Author(s):  
Xubo Lin ◽  
Lei Xu ◽  
Aiqin Wu ◽  
Chuangen Guo ◽  
Xiao Chen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Roc Analysis ◽  
Texture Features ◽  
Arterial Phase ◽  
Portal Phase ◽  
Contrast Enhanced ◽  
Lymph Node Enlargement ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Background Intrapancreatic accessory spleens (IPASs) are usually misdiagnosed as pancreatic neuroendocrine tumors (PNETs). Texture analysis is valuable in tumor detection, diagnosis, and staging. Purpose To identify the potential of texture features in differentiating IPASs from small hypervascular PNETs. Material and Methods Twenty-one patients with PNETs and 13 individuals with IPASs who underwent pretreatment dynamic contrast-enhanced computed tomography (CT) were retrospectively analyzed. The routine imaging features—such as location, size, margin, cystic or solid appearance, enhancement degree and pattern, and lymph node enlargement—were recorded. Texture features, such as entropy, skewness, kurtosis, and uniformity, on contrast-enhanced images were analyzed. Receiver operating characteristic (ROC) analysis was performed to differentiate IPASs from PNETs. Results No significant differences were observed in margin, enhancement degree (arterial and portal phase), lymph node enlargement, or size between PNETs and IPASs (all P > 0.05). However, IPASs usually showed heterogeneous enhancement at the arterial phase and the same degree of enhancement as the spleen at the portal phase, both of which were greater than those of PNETs (69% vs. 35%, P = 0.06; 100% vs. 29%, P = 0.04). Entropy and uniformity were significantly different between IPASs and PNETs at moderate (1.5) and high sigma values (2.5) (both P < 0.01). ROC analysis showed that uniformity at moderate and high sigma had the highest area under the curve (0.82 and 0.89) with better sensitivity (85.0–95.0%) and acceptable specificity (75.0–83.3%) for differentiating IPASs from PNETs. Conclusions Texture parameters have potential in differentiating IPASs from PNETs.

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