Contrast enhanced ultrasound and magnetic resonance imaging in hepatocellular carcinoma diagnosis

Dumitrescu, Cristiana Iulia; Gheonea, Ioana Andreea; Săndulescu, Larisa; Șurlin, Valeriu; Săftoiu, Adrian; Dumitrescu, Daniela

doi:10.11152/mu.2013.2066.154.cd2

Cited by 19 publications

(17 citation statements)

References 32 publications

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“…New imaging techniques have emerged as sensitive and reproducible tools for diagnosis, monitoring and assessing the prognosis in different area of research, and their good performance has been proved by several studies [8][9][10][11]. Ultrasonography (US), an imaging method with several advantages that has made it lately indispensable in daily medical practice, has an unquestionable value in RA, and offered new opportunities by defining and outlining certain pathologic aspects regarding synovial inflammation, the characteristic hallmark of this disease [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

High frequency ultrasonography of the hand versus anti-RA33 evaluation in early rheumatoid arthritis - a pilot study

et al. 2017

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Aim: Accurate diagnosis and early treatment in rheumatoid arthritis (RA) can lead to a good outcome and a correct management of the disease. We aimed toinvestigate the prognostic value of anti-RA33 antibodies, by evaluating the relationship with ultrasonographic (US) findings in patients with early RA.Material and methods: We performed a prospective study which included 29 patients, diagnosed with early RA according to the ACR/EULAR 2010 criteria and 21 sex and age-matched control subjects. All patients underwent clinical and biological assessment, followed by US examination in grayscale (GS) and power Doppler (PD) at baseline and after 12 months [from the second to the fifth metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints and wrists (RCC), in dorsal aspect]. The second and fifth MCP joints were scanned also in lateral aspects.Results: The initial GS evaluation revealed the presence of synovitis in all 29 patients; PD found at least one joint with a PD grade higher than 1 in 23 patients, higher than 2 in 20 patients, and grade 3 in 6 patients; at 12 months, we revealed the presence of GSUS synovitis in 25 patients and PDUS examination found active synovitis in 12 subjects. In those patients, the anti-RA33 titre was significantly lower compared to those without PDUS active synovitis (p=0.031), with a moderately negative correlation (r=-0.519, p=0.0039).Conclusions: The current study shows that anti-RA33 antibodies might constitute an additional tool for diagnosing early RA patients and can help identify patients with mild disease and a low level of activesynovitis.

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Section: Introductionmentioning

confidence: 99%

High frequency ultrasonography of the hand versus anti-RA33 evaluation in early rheumatoid arthritis - a pilot study

et al. 2017

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“…La especificidad de la RMN en el presente estudio fue de 75%, menor de lo reportada por otros estudios del 82 al 98.9% 5,6 ; pero hay que tener en cuenta que en nuestro estudio el 57.6% eran nódulos menores de 1 cm y con una media de diámetro de lesión mucho menor de lo reportada por estas investigaciones, teniendo nódulos de 17 a 52 mm como diámetro promedio, además que su muestra estaba constituida por pacientes cirróticos y no cirróticos 6 ; y en nuestro caso todos nuestros pacientes tenían cirrosis, y como es sabido el patrón macronodular, micronodular y arquitectura heterogénea en estos pacientes aumenta el grado de dificultad en relación a la interpretación de las imágenes, considerando además que el 58.6% recibió algún tipo de tratamiento de ablación previo a las imágenes y al trasplante.…”

Section: Discussionunclassified

La Resonancia Magnética Nuclear De La Hepatocarcinoma en La Cirrosis Hepática Y Los Hallazgos De La Patología Del Explante Hepático

Cornejo-Carrasco¹

2017

RFMH

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RESUMENObjetivos: Determinar la sensibilidad y especificidad de la RMN trifásica con gadolinio en la detección de hepatocarcinoma en pacientes cirróticos que fueron a trasplante hepático y su correlación con los hallazgos del estudio patológico del explante hepático. Métodos: Estudio retrospectivo de pacientes con cirrosis y hepatocarcinoma a los que se les realizaron trasplante hepático con donante cadavérico. Resultados: De los 76 trasplantes hepáticos, 29 pacientes presentaban hepatocarcinoma y cirrosis hepática. La RMN detectó el 80.95% de la hepatocarcinoma activos, encontró 25 nódulos (32.1%) y no detectó 53 nódulos (67.9%) de los 78 nódulos con hepatocarcinoma encontrados en el estudio patológico del explante hepático. La sensibilidad de la RMN fue de 32% y la especificidad del 75%. El diámetro promedio del nódulo detectado fue de 16.28 mm ± 13.82 mm y no detectado fue de 7.62 mm ± 5,68 mm (p=0.001). Hubo una baja detección de la RMN en los nódulos displásicos con focos de hepatocarcinoma y hepatocarcinoma bien diferenciado. En el estudio del explante hepático el 57.1% de los pacientes estuvieron dentro de los criterios de Milán y el 42.8% excedieron estos criterios y dentro del Up-to-seven estuvieron el 80.9%. Conclusión: La sensibilidad de la RMN mejoró cuando el nódulo de hepatocarcinoma fue mayor de 1 cm, moderadamente o pobremente diferenciado; por lo que en varios casos se estaría infravalorando el estadio tumoral y con ello llevando a trasplante hepático a pacientes con menor pronóstico de sobrevida. ABSTRACTObjective: To determine the sensitivity and specificity of three-phase MRI with gadolinium in the detection of hepatocellular carcinoma (HCC) in cirrhotic patients who underwent liver transplantation and its correlation with the findings of the pathological study of the liver explant. Methods: Aretrospective study of patients with cirrhosis and HCC who underwent liver transplantation with a cadaveric donor. Results: Of the 76 liver transplantation performed, 29 patients had HCC and liver cirrhosis. MRI detected 80.95% of active HCC, found 25 nodules (32.1%) and didn´t detect 53 nodules (67.9%) of the 78 nodules with HCC found in the pathological study of the liver explant. The sensitivity of the MRI was 32% and the specificity was 75%. The mean diameter of the nodule detected was 16.28 mm ± 13.82 mm and not detected was 7.62 mm ± 5.68 mm (p = 0.001). MRI had low detection of dysplastic nodules with foci of hepatocellular carcinoma and well differentiated. In the liver explant study, 57.1% of patients were within the criteria of Milan and 42.8% exceeded these criteria and within the Up-to-seven were 80.9%. Conclusion: MRI sensitivity improved when the nodule of HCC was greater than 1 cm, moderately or poorly differentiated; so in several cases the tumor stage would be underestimated and thus leading to liver transplantation in patients with a lower survival prognosis.Key words: Hepatocellular carcinoma; Dysplastic nodules; Liver transplantation, Liver explant; Liver cirrosis; Magnetic resonance...

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“…Hepatocellular carcinoma tumours typically have arteriovenous shunts within the tumour that connect the arterial supply to the venous drainage . With Doppler sonography, HCC appears hypervascular with chaotic blood flow, often appearing in a “basket pattern” with colour Doppler .…”

Section: Grey‐scale Ultrasonography Of Focal Liver Lesionsmentioning

confidence: 99%

“…Focal nodular hyperplasia occurs in approximately 1% to 3% of the population and accounts for approximately 8% of all hepatic tumours . The most frequently occurring primary malignant liver lesions are hepatocellular carcinoma (HCC) and metastasis . Hepatocellular carcinoma occurs in 9 of 100 000 men and 3 of 100 000 women annually in North America .…”

Section: Introductionmentioning

confidence: 99%

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The use of contrast‐enhanced ultrasonography for the characterisation of focal liver lesions

Bagley

Paul

Halferty³

et al. 2018

Sonography

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Focal liver lesions often occur with or without an underlying liver disease. Contrastenhanced ultrasonography can aid in characterising liver lesions, potentially avoiding biopsy and computed tomography procedures. Contrast-enhanced ultrasonography has a high sensitivity and specificity for differentiating characteristics of liver lesions compared with noncontrast sonography. The different contrast characteristics aid in differentiating benign and malignant lesions. Malignant lesions tend to have washout of contrast in the venous phases, whereas benign lesions have hyperenhancement during the venous phases. Therefore, contrast-enhanced ultrasonography should be considered an essential component of the diagnostic process for diagnosing and following focal liver lesions. Funding: None. Conflict of interest: None. Sonography 5 120-134 Reproduced with permission from the Journal of Diagnostic Medical Sonography The use of contrast-enhanced ultrasonography for the characterisation of focal liver lesions J. E. Bagley et al. Sonography 5 120-134 Reproduced with permission from the Journal of Diagnostic Medical Sonography

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Contrast enhanced ultrasound and magnetic resonance imaging in hepatocellular carcinoma diagnosis

Cited by 19 publications

References 32 publications

High frequency ultrasonography of the hand versus anti-RA33 evaluation in early rheumatoid arthritis - a pilot study

High frequency ultrasonography of the hand versus anti-RA33 evaluation in early rheumatoid arthritis - a pilot study

La Resonancia Magnética Nuclear De La Hepatocarcinoma en La Cirrosis Hepática Y Los Hallazgos De La Patología Del Explante Hepático

The use of contrast‐enhanced ultrasonography for the characterisation of focal liver lesions

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