Differentiating biliary cystadenomas from benign hepatic cysts: Preliminary analysis of new predictive imaging features

Kovacs, Mark D.; Sheafor, Douglas H.; Burchett, Philip; Picard, Melissa M.; Hardie, Andrew D.

doi:10.1016/j.clinimag.2017.10.022

Cited by 24 publications

(16 citation statements)

References 13 publications

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“…Internal septa can be calcified [ 3 ]. Septations arising from the internal cyst wall without external indentation seem to be a specific sign that can be relied upon to differentiate MCN-L from SHC [ 7 ].…”

Section: Cystic Tumoursmentioning

confidence: 99%

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Cystic liver lesions: a pictorial review

et al. 2022

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Hepatic cysts (HC) are sac-like structures mainly filled with liquid and showing a distinct membrane. They are usually found incidentally through imaging. A wide spectrum of imaging patterns may be observed for common and uncommon, neoplastic and non-neoplastic diseases. While simple hepatic cysts occur frequently and do not require any treatment or follow-up, non-typical cysts should be carefully analysed to avoid misdiagnosing a lesion that would require appropriate management. Therefore, adequate knowledge of all the relevant imaging patterns is critical to secure an accurate diagnosis. The aim of this review is to describe the imaging features of the different types of hepatic cysts.

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Section: Cystic Tumoursmentioning

confidence: 99%

“…Radiologists should both know and recognise non-typical benign features—i.e. wall thickness, presence of septa, tissular component, enhancement, and signal intensity on MRI [ 7 , 9 ]—and systematically take the clinical context into consideration.…”

Section: Introductionmentioning

confidence: 99%

Cystic liver lesions: a pictorial review

et al. 2022

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“…A recent study by Kovacs et al performed in 25 patients with either complex hepatic cysts or BCA showed that the relationship between septations and the wall of the cystic lesion might be more predictive for a diagnosis than previously reported imaging features. 31 Although the sample size in this study was small, the results are promising and should be explored further.…”

Section: Discussionmentioning

confidence: 80%

The impact of imaging on the surgical management of biliary cystadenomas and cystadenocarcinomas; a systematic review

Klompenhouwer

Cate

Willemssen

et al. 2019

HPB

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Background: Biliary Cystadenomas (BCA) are considered to be benign but may transform to Biliary Cystadenocarcinomas (BCAC). The aim of this systematic review was to assess the diagnostic work-up and necessity of complete surgical resection. Method: A systematic literature search was performed in Embase.com, Medline (Ovid), Cochrane Central, Web-of-Science and Google Scholar. Articles reporting on diagnostic work-up or outcome of various treatment strategies were included.Results: Fifty-one articles with 1218 patients were included: 971 with BCA and 247 with BCAC. Patients with BCA were more often female (91% vs 63.8%, p < 0.001). On radiologic imaging BCAC more often had calcifications (p = 0.008), mural nodules (p < 0.001) and wall enhancement (p < 0.001). Reported treatment strategies were resection, enucleation, or fenestration/marsupialization. Recurrence was reported in 5.4% after resection for BCA and 4.8% after resection for BCAC. Recurrence after fenestration/marsupialization varied from 81.6% to 100% for both BCA as BCAC. Mortality rate was 0 in patients with BCA and 24% in BCAC. Conclusion:Due to the difficulty in accurately diagnosing these biliary cystic lesions and the availability of different surgical approaches, patients with suspected BCA or BCAC should be treated in a center specialized in liver surgery with state-of-the-art imaging and all surgical techniques to prevent mismanagement of this rare disease.

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“…The morphology of septations may be helpful as septations arising from a cyst wall without external indentation have a very high association with MCNs. 126,130 Internal haemorrhage may be seen in MCNs but is much more frequent in simple hepatic cysts and does not represent a worrisome finding.…”

Section: Recommendationsmentioning

confidence: 99%