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Hepatocarcinoma fibrolamelar un tumor de adultos jóvenes poco frecuente. . Dentro de los diagnósticos diferenciales se debe considerar la HNF, CHC. Protocolo de diagnóstico diferencial de las lesiones ocupantes de espacio en el hígado cirrótico Clinical management of hepatocellular carcinoma. Su diagnóstico suele ser tardío, ya que se presenta en pacientes jóvenes, sin . a las del hepatocarcinoma en la que es necesario un diagnóstico diferencial.

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Radiology ; 2: Radiology ; 1: Services on Demand Journal. The biliary excretion of hepatobiliary contrast agents allows for the anatomical and functional characterization of intra- and extrahepatic biliary tract. Cancer ; Well-differentiated HCCs contain functioning hepatocytes and might show hepatobiliary contrast uptake.

Advances in anatomic pathology ; 14 3: Journal of clinical oncology: Note the capacity of hepatobiliary contrast to detect very small lesions which cannot be visualized on the other sequences. Fibrolamellar variant of hepatocellular carcinoma. Clinical value of MRI liver-specific contrast agents: Male, year-old patient presenting with chronic C virus hepatopathy.

Thus, in the hepatobiliary phase, most adenomas are hypointense in relation to the surrounding parenchyma Figure 3. MR imaging of hypervascular lesions in the cirrhotic liver: As the gadoxetic acid dose corresponds to one quarter of the habitual extracellular gadolinium dose, the arterial phase acquisition time is critical, requiring temporal precision methods, such as real time visualization of the contrast progression through the arterial system, for the success in this phase acquisition.

Cancer ; 6: Radiology ; 3: The typical FNH presents with septa and lobulated or microlobulated borders, with intermediate signal intensity on T1- and T2-weighted sequences, low lesion-organ contrast and homogeneous arterial contrast uptake, with decay in the subsequent phases, becoming isointense to the adjacent liver parenchyma.

However, in cases of advanced cirrhosis, the contrast uptake by the liver parenchyma may be compromised by decreased hepatocytes function, which would result in reduction of the method’s accuracy to detect HCCs 4 Contrast uptake is also observed in focal liver lesions with functioning hepatocytes 1.


In cirrhosis, the hepatobiliary contrast uptake by the nodules depends on their differentiation stage and on the presence of functioning hepatocytes.

However, considering that hemangiomas are common lesions, they will be frequently present on images acquired with hepatobiliary contrast for several reasons. Effect of flip angle for optimization of image quality of gadoxetate disodium-enhanced biliary imaging at 1. Small nodules are observed adjacent to the gallbladder, with hyposignal on T2-weighted sequence, without expression on the other sequences and on the conventional dynamic study, but with hepatobiliary contrast uptake, leading to the diagnosis of regenerative nodules.

Patients with advanced liver and kidney diseases alternatively compensate the contrast agents clearance by renal or biliary excretion, respectively. The pharmacokinetics and doses of gadobenate dimeglumine and gadoxetic acid are different.

Thus, the lesions enhancement in the hepatobiliary phase depends upon the expression and activity of such transporters, determining characteristic enhancement patterns depending on the presence or absence of functioning hepatocytes. The caudate lobe lesion arrowheads presents subtle hypersignal on T2-weighted sequence and signal loss on T1-weighted out-of-phase sequence caused by the presence of intralesional fat.

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Caroli’s disease complicated with liver abscess: Accuracy of ultrasonography, spiral CT, magnetic resonance and alpha-fetoprotein in diagnosing hepatocellular carcinoma: Adenomas are well defined, homogeneous or heterogeneous lesions.

In the hepatobiliary phase, the healthy liver is evenly enhanced, becoming hyperintense; the contrast agent uptake by the biliary tract occurs progressively, and the blood vessels become hyperintense as compared with the liver parenchyma as the contrast medium is no longer in the vascular compartment.

A potential confusion factor is the fact that some hemangiomas may present subtle central contrast uptake during the early hepatobiliary hepatocarcinomx because of the tendency to persistent centripetal enhancement at dynamic study, like in those with extracellular gadolinium 1. Modern imaging evaluation of the liver: Clinicopathologic features and survival in fibrolamellar carcinoma: AMA journal of diseases of children ; 91 2: Metastases do not contain functioning hepatocytes or biliary ducts, and do not show contrast uptake during the hepatobiliary phase.


Primary and secondary hepatic neoplasms. Unique phenotype of hepatocellular cancers with exon-3 mutations in beta-catenin gene. Spontaneous perforation of gallbladder with intrahepatic biloma formation: A US population-based study. The hepatobiliary contrast may contribute to the diagnosis of cholecystitis as the gallbladder is not filled by diagnostiico contrast medium, differently from its habitual diferencixl with other contrast agents.

Fibrolamellar hepatocellular carcinoma: a case report

Journal of the American College of Surgeons ; 6: How to cite this article. Case reports in oncology ; 5 1: Additionally, hepatobiliary contrast agents allow for evaluating the biliary tract 1 – 3.

Liver abscesses secondary to acute cholangitis. Hemangiomas normally have a typical presentation at MRI with extracellular contrast and are not an indication for investigation with hepatobiliary contrast. Contrast enhancement of liver lesions in cirrhotic patients: Clinicopathologic characteristics and survival outcomes of patients with fibrolamellar carcinoma: The smallest lesion arrowheads presents subtle hypersignal on T2-weighted and marked signal loss on out-of-phase T1-weighted sequence caused by the presence of intralesional fat.

How to cite this article. Adverse effects of hepatobiliary contrast agents rarely occur and, if present, are similar to the ones reported in the use of extra-cellular gadolinium. Hepatology ; 39 3: Focal hepatic lesions, Hepatobiliary contrast, Magnetic resonance imaging.