Imaging Findings in Cirrhotic Liver: Pearls and Pitfalls for                     Diagnosis of Focal Benign and Malignant Lesions

Liu, Xiaoyang; Tan, Stephanie B. M.; Awiwi, Muhammad O.; Jang, Hyun-Jung; Chernyak, Victoria; Fowler, Kathryn J.; Shaaban, Akram M.; Sirlin, Claude B.; Furlan, Alessandro; Marks, Robert M.; Elsayes, Khaled M.

doi:10.1148/rg.230043

Cited by 3 publications

(2 citation statements)

References 64 publications

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“…Fontan failure was defined as death, takedown, transplantation, or protein-losing enteropathy (PLE). Liver cirrhosis was defined as the advanced irreversible stage of progressive hepatic fibrosis characterized by distortion of hepatic architecture and formation of regenerative nodules ( 15 ). Clinically significant arrhythmia was defined as an arrhythmia requiring antiarrhythmic medication, cardioversion/defibrillation, or pacing devices.…”

Section: Methodsmentioning

confidence: 99%

The long-term effects of the fenestration in patients with extracardiac Fontan circulation—a multicenter Korean cohort study based on national Fontan registry

Ko,

Song,

Chi

et al. 2024

Front. Cardiovasc. Med.

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IntroductionThe long-term effects of fenestration in patients with Fontan circulation remain unclear. We aim to evaluate the fenestration impact on early and late outcomes in patients with extracardiac Fontan (ECF) using a propensity score matching analysis.MethodsWe performed an extensive retrospective multicenter clinical data review of the Korean Fontan registry and included 1,233 patients with surgical ECF (779 fenestrated, 454 non-fenestrated). Demographics, baseline, and follow-up data were collected and comprehensively analyzed. Patients were divided into two groups according to the baseline presence or absence of surgical fenestration. Subsequently, patients were sub-divided according to the fenestration status at the last follow-up. Propensity-score matching was performed to account for collected data between the 2 groups using a multistep approach. The primary outcomes were survival and freedom from Fontan failure (FFF). We also looked at postoperative hemodynamics, cardiopulmonary exercise test results, oxygen saturations, and functional status.ResultsAfter propensity-score matching (454 matched pairs), there was no difference in survival or FFF between the 2 groups. However, ECF patients with baseline fenestration had significantly lower oxygen saturation (p = 0.001) and lower functional status (p < 0.001). Patients with fenestration had significantly longer bypass times, higher postoperative central venous pressure, higher postoperative left atrial pressure, and less prolonged pleural effusion in the early postoperative period. The propensity score matching according to the fenestration status at the last follow-up (148 matched pairs) showed that patients with a persistent fenestration had significantly lower oxygen saturation levels (p < 0.001). However there were no intergroup differences in the functional status, survival and FFF.ConclusionsOur results showed no long-term benefits of the Fenestration in terms of survival and FFF. Patients with persistent fenestration showed oxygen desaturation but no difference in exercise intolerance was shown between the 2 groups.

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Section: Methodsmentioning

confidence: 99%

The long-term effects of the fenestration in patients with extracardiac Fontan circulation—a multicenter Korean cohort study based on national Fontan registry

Ko,

Song,

Chi

et al. 2024

Front. Cardiovasc. Med.

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“…Contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging (MRI) are commonly used imaging modalities for the effective characterization of focal liver lesions[ 6 , 7 ]. Due to the development of contrast-enhanced ultrasonography (CEUS) and its newly developed contrast agents, CEUS has good application value for monitoring the perfusion status of hepatic foci and hepatic parenchyma around lesions[ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Rare infiltrative primary hepatic angiosarcoma: A case report and review of literature

Lin,

Luo

2024

World J Gastrointest Oncol

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BACKGROUND The most primary sites of angiosarcoma are the skin, breast gland, and soft tissues. Primary hepatic angiosarcoma (PHA) is a rare malignant tumor of mesothelial tissue originating from the liver. PHA often presents with multiple intrahepatic foci or metastasis at the time of presentation due to its nonspecific clinical presentation and highly aggressive nature. There are no established or effective treatment guidelines for PHA, so early detection and early treatment are of great value for patient survival. Unfortunately, there is a paucity of literature on the imaging features of PHA, making the diagnosis and treatment of this disease a considerable challenge. CASE SUMMARY In this case report, we present a 59-year-old man who initially presented with abdominal pain and radiating pain in the right shoulder. Magnetic resonance imaging and positron emission tomography-computed tomography revealed multiple intrahepatic nodules that needed to be differentiated from tumors of vascular epithelial origin and tumors with progressive enhancement features, and signs of tumor metastasis were assessed. The patient was then subjected to contrast-enhanced ultrasonography (CEUS) to further clarify the extent of tumor infiltration and the state of microcirculatory perfusion. The manifestations observed on CEUS were similar to the classical characteristic presentation of hepatocellular carcinoma, called "quick wash-in and quick wash-out". In addition, CEUS showed that the lesion exhibited gradual infiltration and growth along the liver pedicle structures with no invading blood vessels. Finally, based on pathological and immunohistochemical tests and the above imaging manifestations, it was confirmed that the patient had infiltrating PHA, which is a rare pathological type of PHA. The patient underwent transcatheter arterial chemoembolization and chemotherapy. Four months after the onset of symptoms, the follow-up radiological examination revealed poor treatment efficacy and rapid deterioration. CONCLUSION This case report complements the imaging modalities of a rare infiltrative PHA, in which CEUS and quantitative analysis are found to offer substantial advantages in characterizing the microcirculatory perfusion of the lesion, providing clinicians with diagnostic information at the earliest opportunity to make a diagnosis and develop a treatment strategy to prolong the patient survival.

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Protocolo diagnóstico de las lesiones ocupantes de espacio hepáticas en el hígado cirrótico

de la Iglesia,

Guerrero

2024

Medicine - Programa de Formación Médica Continuada Acreditado

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Imaging Findings in Cirrhotic Liver: Pearls and Pitfalls for Diagnosis of Focal Benign and Malignant Lesions

Cited by 3 publications

References 64 publications

The long-term effects of the fenestration in patients with extracardiac Fontan circulation—a multicenter Korean cohort study based on national Fontan registry

The long-term effects of the fenestration in patients with extracardiac Fontan circulation—a multicenter Korean cohort study based on national Fontan registry

Rare infiltrative primary hepatic angiosarcoma: A case report and review of literature

Protocolo diagnóstico de las lesiones ocupantes de espacio hepáticas en el hígado cirrótico

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