Document Detail


How to differentiate liver lesions in cirrhosis.
MedLine Citation:
PMID:  18376759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The diagnosis of hepatocellular carcinoma is based on imaging examinations in combination with clinical and laboratory findings. Despite technological advances, imaging cirrhotic patients remains a challenging issue, since preneoplastic hepatocellular lesions, such as dysplastic nodules, mimic a small hepatocellular carcinoma. One of the key pathologic factors for differential diagnosis that is reflected in imaging appearances is the vascular supply to the lesion. It is accepted that imaging techniques may establish the diagnosis of hepatocellular carcinoma in nodules larger than 1 cm showing arterial hypervascularization and venous wash-out. In lesions that do not show a typical pattern, biopsy is still recommended. Contrast-enhanced ultrasound, spiral computed tomography or dynamic magnetic resonance imaging are required for characterization of lesions in cirrhotic liver. However, during the development of hepatocellular carcinoma, significant histological changes are present with or without an evident arterial supply of the nodule. Due to the ability of magnetic resonance to investigate differences in soft tissues and to exploit the properties of tissue-specific contrast agents, this imaging modality is particularly useful in the demonstration of the pathologic changes that take place at the histological level and at the level of the biliary and reticuloendothelial systems during carcinogenetic process in liver cirrhosis.
Authors:
C Bartolozzi; L Crocetti; M C Della Pina
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  JBR-BTR : organe de la Société royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR)     Volume:  90     ISSN:  0302-7430     ISO Abbreviation:  JBR-BTR     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888280     Medline TA:  JBR-BTR     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  475-81     Citation Subset:  IM    
Affiliation:
Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy. bartolozzi@med.unipi.it
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Hepatocellular / blood supply,  diagnosis*,  pathology,  ultrasonography
Contrast Media
Diagnosis, Differential
Diagnostic Imaging*
Humans
Liver Cirrhosis / diagnosis*,  pathology,  ultrasonography
Liver Neoplasms / blood supply,  diagnosis*,  pathology,  ultrasonography
Magnetic Resonance Imaging
Sensitivity and Specificity
Tomography, Spiral Computed
Chemical
Reg. No./Substance:
0/Contrast Media

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