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Quantification of Liver Fat Content after Radiofrequency Ablation for Liver Cancer: Correlation with Hepatic Perfusion Disorders. Diagnostics (Basel) 2021; 11:diagnostics11112137. [PMID: 34829484 PMCID: PMC8625447 DOI: 10.3390/diagnostics11112137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/12/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To quantitatively investigate the correlation between liver fat content and hepatic perfusion disorders (HPD) after radiofrequency ablation (RFA) for liver cancer using magnetic resonance imaging (MRI)-determined proton density fat fraction (PDFF). MATERIALS AND METHODS A total of 150 liver cancer patients underwent liver MRI examination within one month after RFA and at four months after RFA. According to the liver fat content, they were divided into non-, mild, moderate, and severe fatty liver groups. The liver fat content and hepatic perfusion disorders were determined using PDFF images and dynamic contrast-enhanced MRI images. The relationship between the liver fat content and HPD was investigated. RESULTS At the first postoperative MRI examination, the proportion of patients in the nonfatty liver group with hyperperfused foci (11.11%) was significantly lower than that in the mild (30.00%), moderate (42.86%), and severe fatty liver (56.67%) groups (p < 0.05), whereas the proportions of patients with hypoperfused foci (6.67%, 7.5%, 5.71%, and 6.67%, respectively) were not significantly different among the four groups (p > 0.05). In the nonfatty liver group, the liver fat content was not correlated with hyperperfusion abnormalities or hypoperfusion abnormalities. By contrast, in the three fatty liver groups, the liver fat content was correlated with hyperperfusion abnormalities but was not correlated with hypoperfusion abnormalities. At the second postoperative MRI examination, six patients in the nonfatty liver group were diagnosed with fatty liver, including two patients with newly developed hyperperfusion abnormalities and one patient whose hypoperfusion abnormality remained the same as it was in the first postoperative MRI examination. CONCLUSION There was a high correlation between the liver fat content and hyperperfusion abnormalities after RFA for liver cancer. The higher the liver fat content was, the higher the was risk of hyperperfusion abnormalities. However, there was little correlation between liver fat content and hypoperfusion abnormalities, and the increase in postoperative liver fat content did not induce or alter the presence of hypoperfused foci.
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Kedra A, Dohan A, Gaujoux S, Sibony M, Jouinot A, Assié G, Groussin Rouiller L, Libé R, Bertherat J, Soyer P, Barat M. Preoperative Detection of Liver Involvement by Right-Sided Adrenocortical Carcinoma Using CT and MRI. Cancers (Basel) 2021; 13:cancers13071603. [PMID: 33807178 PMCID: PMC8036813 DOI: 10.3390/cancers13071603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/21/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The major prognosis factor of adrenocortical carcinoma is the completeness of surgery. Focal adrenocortical carcinoma bulge on computed tomography and adrenocortical carcinoma contour disruption on magnetic resonance imaging are highly reproducible signs. These signs are strongly associated with direct liver involvement by right-sided adrenocortical carcinoma on preoperative imaging. These findings may help surgeons plan surgical approach before resection and decrease the complication rate. Abstract The major prognosis factor of adrenocortical carcinoma (ACC) is the completeness of surgery. The aim of our study was to identify preoperative imaging features associated with direct liver involvement (DLI) by right-sided ACC. Two radiologists, blinded to the outcome, independently reviewed preoperative CT and MRI examinations for eight signs of DLI, in patients operated for right-sided ACC and retrospectively included from November 2007 to January 2020. DLI was confirmed using surgical and histopathological findings. Kappa values were calculated. Univariable and multivariable analyses were performed by using a logistic regression model. Receiver operating characteristic (ROC) curves were built for CT and MRI. Twenty-nine patients were included. Seven patients had DLI requiring en bloc resection. At multivariable analysis, focal ACC bulge was the single independent sign associated with DLI on CT (OR: 60.00; 95% CI: 4.60–782.40; p < 0.001), and ACC contour disruption was the single independent sign associated with DLI on MRI (OR: 126.00; 95% CI: 6.82–2328.21; p < 0.001). Both signs were highly reproducible, with respective kappa values of 0.85 and 0.91. The areas under ROC curves of MRI and CT models were not different (p = 0.838). Focal ACC bulge on CT and ACC contour disruption on MRI are independent and highly reproducible signs, strongly associated with DLI by right-sided ACC on preoperative imaging. MRI does not improve the preoperative assessment of DLI by comparison with CT.
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Affiliation(s)
- Alice Kedra
- Department of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France; (A.D.); (P.S.); (M.B.)
- Correspondence: ; Tel.: +33-158-412-469
| | - Anthony Dohan
- Department of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France; (A.D.); (P.S.); (M.B.)
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
| | - Sébastien Gaujoux
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
- Department of Surgery, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France
| | - Mathilde Sibony
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
- Department of Pathology, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France
| | - Anne Jouinot
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
- Department of Oncology, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France
| | - Guillaume Assié
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
- Department of Endocrinology, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France;
| | - Lionel Groussin Rouiller
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
- Department of Endocrinology, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France;
| | - Rossella Libé
- Department of Endocrinology, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France;
| | - Jérôme Bertherat
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
- Department of Endocrinology, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France;
| | - Philippe Soyer
- Department of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France; (A.D.); (P.S.); (M.B.)
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
| | - Maxime Barat
- Department of Diagnostic and Interventional Imaging, Hôpital Cochin, Assistance Publique—Hôpitaux de Paris, 75014 Paris, France; (A.D.); (P.S.); (M.B.)
- Faculté de Médecine, Université de Paris, 75006 Paris, France; (S.G.); (M.S.); (A.J.); (G.A.); (L.G.R.); (J.B.)
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Yang B, Si G, He Q, Liu S, Wang S, Xian R, Zhang J, Yu F, Guan J. Multislice Computed Tomographic Manifestation of Transient Hepatic Attenuation Difference in the Left Lobe of the Liver: A Retrospective Study. Adv Ther 2020; 37:3954-3966. [PMID: 32715380 DOI: 10.1007/s12325-020-01428-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Transient hepatic attenuation differences (THAD) are areas of high parenchymal enhancement observed during the hepatic arterial phase on computed tomography (CT). THAD in the left lobe of the liver can lead to surgical complications. METHODS A retrospective study was conducted on patients who underwent multislice computed tomography (MSCT) examination of the upper abdomen to understand the morphology, distribution, and causes of THAD and their correlation with hepatic artery variation. RESULTS Among 179 cases, 65 and 114 belonged to diseased and normal groups, respectively. THAD as observed in MSCT demonstrated various shapes: lobe/segment (127 cases; 70.9%), irregular sheet (31; 17.3%), strip shape (9; 5.02%), arc/semicircle (7; 3.9%), and segment + flaky (5; 2.79%). THAD were found to be caused by liver tumor (32.3%), hepatic inflammatory lesions (6.15%), biliary tract diseases (13.8%), perihepatic disease compression (9.23%), portal vein obstructive disease (1.53%), and lesion in left hepatic lobe with hepatic artery variation (29.2%). THAD exhibited variation in distribution in the left lobe of the liver. Among 114 cases, THAD in 18 (15.7%) cases were observed in the S2 segment, six (5.26%) in the S3 segment, and 90 (78.9%) in multiple segments of the liver, that is, 50 cases in S2 and S3 segments and 40 cases in S2, S3, and S4 segments. The hepatic artery of 179 cases was of various types based on Hiatt classification: 57 cases of Hiatt I (31%), 65 cases of Hiatt II (37%), 11 cases of Hiatt III (6%), 17 cases of Hiatt IV (10%), 7 cases of Hiatt V (4%), 12 cases of large left hepatic artery (7%), 6 cases of right hepatic artery originating from the celiac trunk (3%), and 4 cases (2%) of superior mesenteric artery originating from the celiac trunk. CONCLUSION THAD can occur as a result of specific pathological causes and hence should be considered as a diagnostic sign in liver pathologies.
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Affiliation(s)
- Bin Yang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Guangyan Si
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China.
| | - Qizhou He
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Shulan Liu
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Sikai Wang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Rong Xian
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Jie Zhang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Fei Yu
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Jian Guan
- Department of Radiology, The First Affiliated Hospital of Zhongshan University, Guang Zhou, 510080, Guangdong, People's Republic of China
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