Follow-up of Patients at Low Risk for Hepatic Malignancy with a Characteristic Hemangioma at US

Leifer, David M.; Middleton, William D.; Teefey, Sharlene A.; Menias, Christine O.; Leahy, John R.

doi:10.1148/radiology.214.1.r00ja09167

Cited by 71 publications

(36 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some authors propose surgical resection for patients with progressive abdominal pain in combination with size greater than 5cm [13,14]. So we should know one of the causes of cholestasis is liver hemangioma with pressure in bile duct that can see in sonography and abdominal CT and with surgery the symptom was removed.…”

Section: Resultsmentioning

confidence: 99%

Case Report of Infantile Cholestasis with Liver Hemangioma

Tajik¹

2017

JLRDT

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Case Report of Infantile Cholestasis with Liver Hemangioma

Tajik¹

2017

JLRDT

View full text Add to dashboard Cite

“…Typically, the conventional exam is repeated after 3 to 6 months, and no other imaging exams are done. Some authors recommend a CT or MR in all cases of nodules greater than 1 mm (13,14) . Use of contrast in US has brought new perspectives to the method, and this approach is gradually becoming adopted in hepatology for the differential diagnosis of hepatic nodules, detection of primary carcinomas, transplant assessment, among others (12) .…”

Section: Discussionmentioning

confidence: 99%

“…In patients with nodules detected on conventional US which are deemed typical of hepatic hemangiomas, follow-up using conventional US should suffice (13) . However, in patients with undefined nodules on conventional US, an US with contrast should be the second imaging method indicated.…”

Section: Discussionmentioning

confidence: 99%

Prospective study of ultrasound with perflutrene contrast compared to magnetic resonance imaging in the diagnosis of hepatic hemangiomas

Schmillevitch

Szutan²,

Ferreira³

et al. 2011

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -The incidence of hepatic hemangiomas ranges from 0.4% to 20% in the general population. Conventional ultrasound is usually the first diagnostic method to identify these hemangiomas, typically as an incidental finding. Ultrasonography with second generation contrast materials is being used in various areas of hepatology, yielding similar results to those obtained with computerized tomography and magnetic resonance imaging in the diagnosis of hepatic hemangiomas. Objective -To evaluate the agreement between ultrasound with perflutrene contrast and magnetic resonance imaging in the diagnosis of hepatic hemangiomas.Methods -A total of 37 patients were prospectively examined between January 2006 and August 2008. A total of 57 hepatic nodules were documented in this group as incidental findings on routine ultrasound exams. The 37 patients were administered perflutrene contrast without adverse reactions, and were all submitted to magnetic resonance exams. Results -Conventional ultrasound identified 15 patients with nodules typical of hemangiomas and 22 patients with other nodules. In 35 patients, the contrast characteristics were consistent with hepatic hemangiomas. Conclusion -Agreement between the data obtained from ultrasound with contrast and magnetic resonance was 94.5%. In discordant cases, the magnetic resonance diagnosis prevailed. In the case which presented indeterminate findings on contrast ultrasonography, magnetic resonance was repeated after 3 months, confirming the diagnosis of a hepatic hemangioma. A biopsy was performed on the suspected malignant nodule which also confirmed the presence of a hepatic hemangioma. Ultrasonography with contrast has the advantages of being more accessible to the public at large and lower cost than magnetic resonance. The results of our study highlight the need for a new protocol in hepatic nodules incidentally identified on conventional ultrasonography. In the case of typical hemangiomas, conventional ultrasound is sufficient for diagnosis. However, for poorly defined nodules, ultrasonography with contrast is indicated. After confirming the presence of a hepatic hemangioma on contrast ultrasonography, no further exams are needed to finalize the diagnosis.

show abstract

“…If the patient has no risk factors for primary or secondary neoplasms, ultrasound was performed by an experienced technician, and the nodule exhibits all of the typical features of hemangioma, one may forgo additional imaging and perform followup ultrasound after 3 or 6 months instead. Only 0.47% of nodules diagnosed as typical hemangiomas on ultrasound were later found to represent neoplasms (24) . Computed tomography should be performed in a multide tector scanner, with intravenous contrast.…”

Section: Hepatic Hemangiomasmentioning

confidence: 99%

Diagnosis and treatment of benign liver nodules: Brazilian Society of Hepatology (SBH) recommendations

Strauss

Ferreira

França

et al. 2015

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Spaceoccupying lesions of the liver may be cystic or solid. Ultrasonography is an extremely useful method for initial screening, and suffices for diagnosis of simple hepatic cysts. Complex cysts and solid masses require computed tomography or magnetic resonance imaging for confirmation. Wide surgical excision is indicated in cystadenoma or cystadenocarcinoma. Clinical and epidemiological data are important, as nodules in noncirrhotic livers are more likely to be benign. Hemangiomas, the most common benign tumors, require no followup after diagnostic confirmation if they are small and asymptomatic. Patients with giant, symptomatic hemangiomas or compression of adjacent structures should be referred to hepatobiliary centers for potential surgery. The genetic heterogeneity of hepatocellular adenomas and their epidemiology and prognosis prompted classification of these tumors into four subtypes based on histology and immunohistochemistry. The major complications of hepatocellular adenomas are rupture with bleeding and malignant transformation. Rupture occurs in approximately 30% of cases. The main risk factors are tumor size >5 cm and inflammatory subtype. Hepatocellular adenomas may enlarge during pregnancy due to marked hormonal stimulation. As oral contraceptive pills and anabolic steroids have been associated with hepatocellular adenomas growth, particularly of the hepatocyte nuclear factor1alfa subtype, these drugs should be discontinued. Focal nodular hyperplasia is the second most common benign tumor of the liver. It is most frequent in women aged 20 to 60, and 70% to 90% of cases are asymptomatic. In the absence of a central scar and/or other hallmarks of Focal nodular hyperplasia, with uncertainty between this diagnosis and hepatocellular adenoma, liverspecific contrast agents are indicated.

show abstract

Follow-up of Patients at Low Risk for Hepatic Malignancy with a Characteristic Hemangioma at US

Abstract: On the basis of these results, the authors no longer recommend follow-up studies in their patients with a low risk of malignancy and a typical-appearing hemangioma at US.

Cited by 71 publications

References 27 publications

Case Report of Infantile Cholestasis with Liver Hemangioma

Case Report of Infantile Cholestasis with Liver Hemangioma

Prospective study of ultrasound with perflutrene contrast compared to magnetic resonance imaging in the diagnosis of hepatic hemangiomas

Diagnosis and treatment of benign liver nodules: Brazilian Society of Hepatology (SBH) recommendations

Contact Info

Product

Resources

About