By Lencioni Riccardo
Few fields of medication have witnessed such extraordinary development because the prognosis and therapy of liver tumors. Advances in imaging expertise, the improvement of novel distinction brokers, and the advent of optimized scanning protocols have drastically facilitated the non-invasive detection and characterization of focal liver lesions. moreover, image-guided thoughts for percutaneous tumor ablation became an authorised replacement therapy for sufferers with inoperable liver melanoma. This e-book presents a accomplished and updated assessment of the function of diagnostic and interventional radiology in admire of liver tumors. the quantity strikes from historical past sections on technique and segmental liver anatomy to the most sections at the analysis of benign and malignant liver lesions. An built-in process, desirous about the correlation of ultrasound, CT, and MR imaging findings, is gifted. eventually, an entire part describes the rules, tools, and result of percutaneous tumor ablation techniques.
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Few fields of medication have witnessed such striking development because the prognosis and therapy of liver tumors. Advances in imaging expertise, the advance of novel distinction brokers, and the creation of optimized scanning protocols have significantly facilitated the non-invasive detection and characterization of focal liver lesions.
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Additional info for Focal Liver Lesions Medical Radiology
1997). T1-weighted bidimensional (2D) GRE sequences are used to perform dynamic studies throughout the liver. The need to acquire enough sections to cover the whole liver during a breath-hold requires sections of no more than 8–10 mm. Volumetric interpolated breath-hold examination (VIBE) permits the acquisition of isotropic pixels of approximately 2 mm in all dimensions with an acquisition time of less than 25 s. The volumetric data set can be reconstructed in any plane, producing MR angiography and venography that can be useful in the assessment of liver vascular anatomy (Fig.
10). If patients have a history of tumour with possible hypervascular liver metastases (kid- ney, breast, islet cell tumours) a late arterial phase is added to the previous scanning protocol. A completely different approach is dedicated to hepatopathic patients. A pre-contrast scan is questionable since no beneﬁt was obtained in terms of identiﬁcation of hepatocellular carcinoma compared with a dynamic contrast-enhanced study. Mandatory 26 A. Laghi et al. a b Fig. 10a,b. Typical pattern of hypovascular colorectal cancer metastasis.
6) (Ichikawa et al. 1998a; Kim et al. 1999). Taouli et al. 5×10–3 mm2/s, with a diffusion factor (“b”) of 0 and 500 s/mm2, would result in sensitivity, speciﬁcity, positive predictive value, and accuracy of 84%, 89%, 87% and 86% respectively. Moreover, with singleshot echo-planar technique, it is possible to perform a perfusion study of the liver by obtaining images at 1–2 s intervals after a bolus injection of paramagnetic contrast agent. On perfusion-weighted images (which are T2*-weighted images) gadolinium chelates serve as negative contrast agents decreasing the signal in the enhancing lesions (Padhani and Husband 2001).