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Ringe KI, Fischbach F, Grenacher L, Juchems MS, Kukuk G, Lauenstein T, Wessling J, Schreyer AG. Application of liver-specific contrast agents for evaluation of focal liver lesions - Expert recommendations from the Gastrointestinal and Abdominal Imaging Workgroup of the German Roentgen Society. ROFO-FORTSCHR RONTG 2024; 196:690-698. [PMID: 38113896 DOI: 10.1055/a-2192-9921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Affiliation(s)
- Kristina I Ringe
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Frank Fischbach
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Germany
| | - Lars Grenacher
- Imaging and Prevention Center, Conradia Radiology Munich, Germany
| | - Markus S Juchems
- Diagnostic and Interventional Radiology, Hospital Konstanz, Germany
| | - Guido Kukuk
- Department of Radiology, Hospital Graubünden, Chur, Switzerland
| | | | | | - Andreas G Schreyer
- Institute for Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany
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Aslan S, Onder RO, Sulun E, Taşdemir MN. Evaluation of qualitative and quantitative imaging features of hepatic hemangiomas with and without pseudo-washout sign on gadoxetic acid-enhanced MRI: a descriptive and comparative study. Acta Radiol 2024; 65:23-32. [PMID: 37264586 DOI: 10.1177/02841851231177399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Hepatic hemangiomas are the most common benign liver tumors. It is important to know the imaging features of hemangiomas on gadoxetic acid (GA)-enhanced magnetic resonance imaging (MRI). PURPOSE To evaluate the qualitative and quantitative imaging features of hemangiomas on GA-enhanced MRI, and to compare imaging features of hemangiomas with and without pseudo-washout sign (PWS). MATERIAL AND METHODS We retrospectively included 93 cases of hemangioma that underwent GA-enhanced MRI. The presence of an enhancement pattern in the arterial phase (AP) and PWSs in the transitional phase (TP) were evaluated. Signal-to-norm ratios (SINorm) of hemangiomas, liver parenchyma, and portal vein (PV) as well as contrast-to-norm ratio (CNorm) were assessed. Additionally, hemangiomas with and without PWSs were defined as two separate subgroups, and imaging features were compared. RESULTS Of the 93 cases of hemangiomas, 49 (52.6%) had PWSs in the TP. The mean SINorms of hemangiomas showed the highest value in the AP (P < 0.05). The mean CNorms showed positive values in the AP, and gradually decreased (P < 0.05). Hemangiomas with PWSs were significantly rapidly enhanced and smaller in size (P < 0.05), and the mean SINorms was lower in the TP (P = 0.023). While the mean CNorms showed a significant difference in the AP between subgroups (P < 0.001), the enhancement pattern was equal to that of the PV. CONCLUSION When evaluating GA-enhanced MRI, radiologists should utilize quantitative measures in addition to qualitative assessment and should be aware that SI matching with PV in all phases can be a distinguishing finding in the diagnosis of hemangioma.
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Affiliation(s)
- Serdar Aslan
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Ramazan Orkun Onder
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Emrah Sulun
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Merve Nur Taşdemir
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey
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Maino C, Vernuccio F, Cannella R, Cortese F, Franco PN, Gaetani C, Giannini V, Inchingolo R, Ippolito D, Defeudis A, Pilato G, Tore D, Faletti R, Gatti M. Liver metastases: The role of magnetic resonance imaging. World J Gastroenterol 2023; 29:5180-5197. [PMID: 37901445 PMCID: PMC10600959 DOI: 10.3748/wjg.v29.i36.5180] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/28/2023] [Accepted: 09/11/2023] [Indexed: 09/20/2023] Open
Abstract
The liver is one of the organs most commonly involved in metastatic disease, especially due to its unique vascularization. It's well known that liver metastases represent the most common hepatic malignant tumors. From a practical point of view, it's of utmost importance to evaluate the presence of liver metastases when staging oncologic patients, to select the best treatment possible, and finally to predict the overall prognosis. In the past few years, imaging techniques have gained a central role in identifying liver metastases, thanks to ultrasonography, contrast-enhanced computed tomography (CT), and magnetic resonance imaging (MRI). All these techniques, especially CT and MRI, can be considered the non-invasive reference standard techniques for the assessment of liver involvement by metastases. On the other hand, the liver can be affected by different focal lesions, sometimes benign, and sometimes malignant. On these bases, radiologists should face the differential diagnosis between benign and secondary lesions to correctly allocate patients to the best management. Considering the above-mentioned principles, it's extremely important to underline and refresh the broad spectrum of liver metastases features that can occur in everyday clinical practice. This review aims to summarize the most common imaging features of liver metastases, with a special focus on typical and atypical appearance, by using MRI.
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Affiliation(s)
- Cesare Maino
- Department of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
| | - Federica Vernuccio
- University Hospital of Padova, Institute of Radiology, Padova 35128, Italy
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo 90127, Italy
| | - Francesco Cortese
- Unit of Interventional Radiology, F Miulli Hospital, Acquaviva delle Fonti 70021, Italy
| | - Paolo Niccolò Franco
- Department of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
| | - Clara Gaetani
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Valentina Giannini
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Riccardo Inchingolo
- Unit of Interventional Radiology, F Miulli Hospital, Acquaviva delle Fonti 70021, Italy
| | - Davide Ippolito
- Department of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
- School of Medicine, University of Milano Bicocca, Milano 20100, Italy
| | - Arianna Defeudis
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Giulia Pilato
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo 90127, Italy
| | - Davide Tore
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Marco Gatti
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
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Tang T, Wang X, Mao Y, Li J, Wen T, Jia W, Chen Y, Peng T, Liu L, Fan R, Ma K, Xia F. Real-world data on the clinicopathological traits and outcomes of hospitalized liver hemangioma patients: a multicenter study. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1067. [PMID: 34422979 PMCID: PMC8339840 DOI: 10.21037/atm-20-4684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 03/28/2021] [Indexed: 02/05/2023]
Abstract
Background There is currently a lack of consensus regarding the clinical features, diagnosis, treatment indications and options, and risk assessment of hepatic hemangioma patients. Methods This was a multicenter, real-world study that analyzed a large number of hepatic hemangioma cases in China and included patient data on epidemiology, diagnosis, treatment methods, and outcomes. Results A total of 5,143 patients hospitalized for hepatic hemangioma were included, of whom 34.42% were male and 65.58% were female. The age distribution was concentrated between 30 and 60 years old, accounting for 87.41% of the patients. Among the hepatic hemangioma patients, 60.8% had only one tumor, with the most common pathological type being cavernous hemangioma (96.07% of cases). The treatment motivations and indications included anxiety, obvious clinical symptoms, rapid tumor growth, unclear diagnoses and acute emergencies. Overall, 41.4% of the patients were treated for psychological reasons, while 30.59% were treated because they presented obvious (primarily nonspecific) clinical symptoms. Hepatic resection was the main therapeutic method and was based on various indications. There were a small number of patients with Kasabach-Merritt syndrome, according to its generally recognized definition. Conclusions Most patients in this study who were hospitalized for hepatic hemangioma did not meet the indications for requiring treatment. Surveillance is the recommended course of action for definitively diagnosed hepatic hemangioma, and a new classification system is needed to standardize the diagnosis of this condition.
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Affiliation(s)
- Tengqian Tang
- The Institute of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xishu Wang
- The Institute of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yilei Mao
- Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China
| | - Jing Li
- The Institute of Hepatobiliary Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Tianfu Wen
- Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, China
| | - Weidong Jia
- Department of Hepatobiliary Surgery, Anhui Provincial Hospital, Hefei, China
| | - Yongjun Chen
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Peng
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lingxiao Liu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai, China
| | - Ruifang Fan
- Department of Hepatobiliary Surgery, Lanzhou General Hospital of Lanzhou Military Area Command, PLA, Lanzhou, China
| | - Kuansheng Ma
- The Institute of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Feng Xia
- The Institute of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China
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