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 Conspicuity of Malignant Pleural Mesothelioma in Contrast Enhanced MDCT – Arterial Phase or Late Phase?

2021 ◽  
Author(s):  
Lukas Luerken ◽  
Philipp Laurin Thurn ◽  
Florian Zeman ◽  
Christian Stroszczynski ◽  
Okka Wilkea Hamer
Keyword(s):  
Multiple Regression ◽  
Late Phase ◽  
Objective Analysis ◽  
Surrounding Tissue ◽  
Arterial Phase ◽  
Subjective Analysis ◽  
Portal Venous Phase ◽  
Contrast Enhanced ◽  
Venous Phase ◽  
Phase Scan

Abstract Background: To compare two different contrast phases intraindividually regarding conspicuity of MPM in chest MDCT. Methods: 28 patients with MPM were included in this retrospective study. For all patients, chest CT in standard arterial phase and abdominal CT in portal venous phase (scan delay ca. 70 s) was performed. First, subjective analysis of tumor conspicuity was done independently by two radiologists. Second, objective analysis was done by measuring Hounsfield units (HU) in tumor lesions and in the surrounding tissue in identical locations in both phases. Differences of absolute HUs in tumor lesions between phases and differences of contrast (HU in lesion – HU in surrounding tissue) between phases were determined. HU measurements were compared using paired t-test for related samples. Potential confounding effects by different technical and epidemiological parameters between phases were evaluated performing a multiple regression analysis.Results: Subjective analysis: In all 28 patients and for both readers conspicuity of MPM was better on late phase compared to arterial phase. Objective analysis: MPM showed a significantly higher absolute HU in late phase (75.4 vs 56.7 HU, p < 0.001). Contrast to surrounding tissue was also significantly higher in late phase (difference of contrast between phases 18.5 HU, SD 10.6 HU, p < 0.001). Multiple regression analysis revealed contrast phase and tube voltage to be the only significant independent predictors for tumor contrast.Conclusions: In contrast enhanced chest-MDCT for MPM late phase scanning seems to provide better conspicuity and higher contrast to surrounding tissue compared to standard arterial phase scans.

scholarly journals Contrast-enhanced Ultrasound Features of Intrahepatic Cholangiocarcinoma: A New Perspective

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tianjiao Chen ◽  
Xiaoyan Chang ◽  
Ke Lv ◽  
Yong Wang ◽  
Xianshui Fu ◽  
...  
Keyword(s):  
Intrahepatic Cholangiocarcinoma ◽  
Color Doppler ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Color Doppler Flow Imaging ◽  
Portal Venous Phase ◽  
Contrast Enhanced ◽  
Color Doppler Flow ◽  
Venous Phase ◽  
New Perspective

AbstractThe objective of this study was to illustrate our specific findings for intrahepatic cholangiocarcinoma (ICC) lesions on contrast-enhanced ultrasound (CEUS). In this study, 21 patients at our hospitals with pathologically proven ICC and CEUS data were retrospectively enrolled. General clinical data of the patients, and features of lesions on conventional and contrast-enhanced ultrasound were recorded. Two experienced radiologists retrospectively reviewed all images by consensus. On gray-scale sonography, hypoechoic, isoechoic and hyperechoic lesions accounted for 85.7%, 9.5% and 4.8%, respectively, of all lesions. Hypovascular patterns were found for 95.2% of the lesions on color Doppler flow imaging. During the arterial phase of CEUS, heterogeneous hyperenhancement, homogeneous hyperenhancement, rim-like hyperenhancement, isoenhancement and hypoenhancement were observed for 61.9%, 19.0%, 9.5%, 4.8%, 4.8% of the lesions, respectively. During the portal venous and late phases, 85.7% and 95.2% of the lesions, respectively, exhibited hypoenhancement. In addition, 66.7% of the ICC lesions exhibited washed-out interiors but little decrease in enhancement at the periphery during the portal venous phase, resulting in the formation of a hyperenhanced peripheral rim. In conclusion, the rim sign in the portal venous phase of CEUS could help diagnose ICC. This trait could be related to the infiltrating growth pattern of ICC.

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.

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.

scholarly journals Laparoscopic surgical management of a mature presacral teratoma: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Liming Wang ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Hiroka Kondo ◽  
Kiyoka Hara ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Mature Teratoma ◽  
Skin Incision ◽  
Histopathological Diagnosis ◽  
Tailgut Cyst ◽  
Resonance Imaging ◽  
Presumptive Diagnosis ◽  
Case Presentation ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri

Abstract Background Mature presacral (retrorectal) teratoma is very rare. We report a case in which a mature retrorectal teratoma in an adult was successfully treated with laparoscopic surgery. Case presentation A 44-year-old woman was diagnosed with a presacral tumor during a physical examination. Endoscopic ultrasonography (EUS) revealed a multilocular cystic lesion; the lesion was on the left side of the posterior rectum and measured approximately 30 mm in diameter on both contrast-enhanced pelvic computed tomography (CT) and magnetic resonance imaging (MRI). The presumptive diagnosis was tailgut cyst. However, the histopathological diagnosis after laparoscopic resection was mature teratoma. It is still difficult to preoperatively diagnose mature retrorectal teratomas. Conclusions Laparoscopic resection of mature retrorectal teratomas is a feasible and promising method that is less invasive and can be adapted without extending the skin incision.

scholarly journals Uncommon manifestations of a rare disease: a case of autoimmune GFAP astrocytopathy

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hong Di ◽  
Yue Yin ◽  
Ruxuan Chen ◽  
Yun Zhang ◽  
Jun Ni ◽  
...  
Keyword(s):  
Rare Disease ◽  
Hormone Secretion ◽  
White Matter Lesions ◽  
Signs And Symptoms ◽  
Careful Examination ◽  
Case Presentation ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Contrast Enhanced ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Abstract Background Manifestations of intractable hyponatremia and hypokalemia in autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy have been rarely reported. Case presentation A 75-year-old male patient presented as the case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) and intractable hypokalemia, showed fever, fatigue, and mental disorders. Signs and symptoms of meningoencephalitis, ataxia, and cognitive abnormalities. Magnetic resonance imaging (MRI) revealed multiple white matter lesions of the central nervous system. He had GFAP-IgG in the cerebrospinal fluid (CSF). After treatment with corticosteroids, his symptoms were alleviated gradually, and the level of electrolytes was normal. However, head contrast-enhanced MRI + susceptibility-weighted imaging (SWI) showed a wide afflicted region, and the serum GFAP-IgG turned positive. Considering the relapse of the disease, ha was treated with immunoglobulin and mycophenolate mofetil (MMF) to stabilize his condition. Conclusion This case showed a rare disease with uncommon manifestations, suggesting that careful examination and timely diagnosis are essential for disease management and satisfactory prognosis.

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.

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....

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