Uncommon imaging evolutions of focal liver lesions in cirrhosis

Vernuccio, Federica; Cannella, Roberto; Porrello, Giorgia; Calandra, Alberto; Midiri, Massimo; Furlan, Alessandro; Brancatelli, Giuseppe

doi:10.1007/s00261-019-02101-4

Cited by 12 publications

(16 citation statements)

References 32 publications

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“…Furthermore, in a cirrhotic liver, both benign and malignant lesions may lack typical imaging features and so definitive diagnosis may require comparison with previous studies, imaging follow-up, or tissue sampling. 9 Our case report is unique in that this patient with liver cirrhosis and gastric bleeding had multiple infarcted regenerative nodules not only in the liver, but also in the spleen and kidney. The cause of the infarctions in the spleen and kidney may have also resulted from a sudden reduction in blood flow after blood loss or shock.…”

Section: Discussionmentioning

confidence: 77%

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Multiple infarcted regenerative nodules in liver, spleen and kidney after gastric and oesophageal bleeding: A case report

Wang

Shu

2020

J Int Med Res

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Infarcted regenerative nodules in a cirrhotic liver is a rare condition that may be confused with hepatocellular carcinoma on imaging. We report here a case of a 58-year-old man with live cirrhosis who presented with abdominal pain and distension and sudden onset of haematemesis. Computed tomography (CT) showed diffuse multinodular infarcted regenerative nodules and gastric bleeding. Physicians should include infarcted regenerative nodules in any differential diagnosis of multiple hepatic lesions in liver cirrhosis, particularly in patients with gastrointestinal varices.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Multiple infarcted regenerative nodules in liver, spleen and kidney after gastric and oesophageal bleeding: A case report

Wang

Shu

2020

J Int Med Res

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“…It is challenging for abdominal radiologists to detect and characterize focal liver lesions (FLLs) in patients with cirrhosis (1)(2)(3). Cirrhosis is a major risk factor for hepatocellular carcinoma (HCC) (4).…”

Section: Introductionmentioning

confidence: 99%

“…The diagnosis of benign and malignant FLLs in cirrhotic individuals is important. However, in cirrhotic livers, these lesions may lack typical imaging features (1). Therefore, the final diagnosis may need to be verified by tissue sampling (1,5).…”

Section: Introductionmentioning

confidence: 99%

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A Computed Tomography Nomogram for Assessing the Malignancy Risk of Focal Liver Lesions in Patients With Cirrhosis: A Preliminary Study

Wang

Liang

et al. 2022

Front. Oncol.

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PurposeThe detection and characterization of focal liver lesions (FLLs) in patients with cirrhosis is challenging. Accurate information about FLLs is key to their management, which can range from conservative methods to surgical excision. We sought to develop a nomogram that incorporates clinical risk factors, blood indicators, and enhanced computed tomography (CT) imaging findings to predict the nature of FLLs in cirrhotic livers.MethodA total of 348 surgically confirmed FLLs were included. CT findings and clinical data were assessed. All factors with P < 0.05 in univariate analysis were included in multivariate analysis. ROC analysis was performed, and a nomogram was constructed based on the multivariate logistic regression analysis results.ResultsThe FLLs were either benign (n = 79) or malignant (n = 269). Logistic regression evaluated independent factors that positively affected malignancy. AFP (OR = 10.547), arterial phase hyperenhancement (APHE) (OR = 740.876), washout (OR = 0.028), satellite lesions (OR = 15.164), ascites (OR = 156.241), and nodule-in-nodule architecture (OR =27.401) were independent predictors of malignancy. The combined predictors had excellent performance in differentiating benign and malignant lesions, with an AUC of 0.959, a sensitivity of 95.24%, and a specificity of 87.5% in the training cohort and AUC of 0.981, sensitivity of 94.74%, and specificity of 93.33% in the test cohort. The C-index was 96.80%, and calibration curves showed good agreement between the nomogram predictions and the actual data.ConclusionsThe nomogram showed excellent discrimination and calibration for malignancy risk prediction, and it may aid in making FLLs treatment decisions.

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