• Title/Summary/Keyword: Focal liver lesion

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Focal Nodular Hyperplasia in Liver: A Case Report (간 국소 결절성 과형성의 방사선학적 소견)

  • Seong, Ki-Ho;Cho, Jae-Ho;Chang, Jae-Chun
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.400-404
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    • 1995
  • Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonography and hyperdense mass lesion on early-phase IV bolus CT and isodense mass lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.

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Diffusion-Weighted Imaging for the Left Hepatic Lobe has Higher Diagnostic Accuracy for Malignant Focal Liver Lesions

  • Han, Xue;Dong, Yin;Xiu, Jian-Jun;Zhang, Jie;Huang, Zhao-Qin;Cai, Shi-Feng;Yuan, Xian-Shun;Liu, Qing-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6155-6160
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    • 2014
  • Background: This study was conducted to investigate whether apparent diffusion coefficient (ADC) measurements by dividing the liver into left and right hepatic lobes may be utilized to improve the accuracy of differential diagnosis of benign and malignant focal liver lesions. Materials and Methods: A total of 269 consecutive patients with 429 focal liver lesions were examined by 3-T magnetic resonance imaging that included diffusion-weighted imaging. For 58 patients with focal liver lesions of the same etiology in left and right hepatic lobes, ADCs of normal liver parenchyma and focal liver lesions were calculated and compared using the paired t-test. For all 269 patients, ADC cutoffs for focal liver lesions and diagnostic accuracy in the left hepatic lobe, right hepatic lobe and whole liver were evaluated by receiver operating characteristic curve analysis. Results: For the group of 58 patients, mean ADCs of normal liver parenchyma and focal liver lesions in the left hepatic lobe were significantly higher than those in the right hepatic lobe. For differentiating malignant lesions from benign lesions in all patients, the sensitivity and specificity were 92.6% and 92.0% in the left hepatic lobe, 94.4% and 94.4% in the right hepatic lobe, and 90.4% and 94.7% in the whole liver, respectively. The area under the curve of the right hepatic lobe, but not the left hepatic lobe, was higher than that of the whole liver. Conclusions: ADCs of normal liver parenchyma and focal liver lesions in the left hepatic lobe were significantly higher than those in the right hepatic lobe. Optimal ADC cutoff for focal liver lesions in the right hepatic lobe, but not in the left hepatic lobe, had higher diagnostic accuracy compared with that in the whole liver.

Improved Focal Liver Lesion Detection by Increasing Flip Angle During Gadoxetic Acid-Enhancement in MRI (Gadoxetic acid 조영증강 자기공명영상에서 숙임각 변화에 따른 국소 간종양 검출능 비교)

  • Lee, SeJy;Kim, Young-Keun
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.115-120
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    • 2015
  • To study the differences of focal liver lesion image detection at 3 minute, 10 minute and 15 minute time points on gadoxetic acid (GA)'s enhanced MR imaging with a flip angle (FA) of $30^{\circ}$ compared with a $11^{\circ}$. The subjects were 69 patients evaluated with GA enhanced MR imaging with 3.0T MR scanner. The patients are total 35(23 men and 7 women at the mean age of 60.4 years), hepatocellular carcinoma(23) and metastsis(12) except for normal, cyst and hemangioma. After GA was injected, FA $11^{\circ}$ and $30^{\circ}$ images were obtained at 3 minute, 10 minute and 15 minute time points respectively. After quantitative and qualitative assessment of each image was done, statistical analysis was performed by using the independent sample T-test. From both quantitative and qualitative assessment of 3 minute and 10 minute MR images after the injection of GA, FA $30^{\circ}$ images was found to be superior than FA $11^{\circ}$, but there were no statistical significance. However, at 15 minute time point, Statistically significant FA $30^{\circ}$ image(p<0.05) was better than FA $11^{\circ}$ therefore, the FA $30^{\circ}$ improves the focal liver lesion detection. FA $30^{\circ}$ of MR image can detect liver lesion more sensitively than the existing $FA11^{\circ}$ image after GA contrast enhancement at 15 minute time point.

[$^{18}F$]-FDG PET/CT Images of Appendiceal Adenocarcinoma ($^{18}F$-FDG PET/CT로 진단된 충수 선암종)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Kim, Hong-Jin
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.188-189
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    • 2006
  • A 53-year -old man underwent $^{18}F$-FDG whole body PET/CT because of the detected liver mass on abdominal CT. The PET/CT showed a huge liver mass ($9{\times}9cm$, SUV: 12.12 ) in the right lobe and a focally hypermetabolic lesion in the right lower quadrant of abdomen (SUV: 9.12). At first, we suspected that the focal hypermetabolic lesion in RLQ was the physiologic uptake of ureter or a metastatic lesion of small bowel. We repeated the abdominal PET/CT next day. The focally hypermetabolic lesion was identified as the appendiceal mass. He underwent right hemicolectomy and right lobectomy of the liver. It was confirmed that the lesion was appendiceal adenocarcinoma with liver metastasis. Cancer of the appendix is an uncommon disease that is rarely suspected before surgery. But, we suggest that PET/CT is useful to identify the small lesion like appendiceal malignant mass.

Image Quality and Lesion Detectability of Lower-Dose Abdominopelvic CT Obtained Using Deep Learning Image Reconstruction

  • June Park;Jaeseung Shin;In Kyung Min;Heejin Bae;Yeo-Eun Kim;Yong Eun Chung
    • Korean Journal of Radiology
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    • v.23 no.4
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    • pp.402-412
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    • 2022
  • Objective: To evaluate the image quality and lesion detectability of lower-dose CT (LDCT) of the abdomen and pelvis obtained using a deep learning image reconstruction (DLIR) algorithm compared with those of standard-dose CT (SDCT) images. Materials and Methods: This retrospective study included 123 patients (mean age ± standard deviation, 63 ± 11 years; male:female, 70:53) who underwent contrast-enhanced abdominopelvic LDCT between May and August 2020 and had prior SDCT obtained using the same CT scanner within a year. LDCT images were reconstructed with hybrid iterative reconstruction (h-IR) and DLIR at medium and high strengths (DLIR-M and DLIR-H), while SDCT images were reconstructed with h-IR. For quantitative image quality analysis, image noise, signal-to-noise ratio, and contrast-to-noise ratio were measured in the liver, muscle, and aorta. Among the three different LDCT reconstruction algorithms, the one showing the smallest difference in quantitative parameters from those of SDCT images was selected for qualitative image quality analysis and lesion detectability evaluation. For qualitative analysis, overall image quality, image noise, image sharpness, image texture, and lesion conspicuity were graded using a 5-point scale by two radiologists. Observer performance in focal liver lesion detection was evaluated by comparing the jackknife free-response receiver operating characteristic figures-of-merit (FOM). Results: LDCT (35.1% dose reduction compared with SDCT) images obtained using DLIR-M showed similar quantitative measures to those of SDCT with h-IR images. All qualitative parameters of LDCT with DLIR-M images but image texture were similar to or significantly better than those of SDCT with h-IR images. The lesion detectability on LDCT with DLIR-M images was not significantly different from that of SDCT with h-IR images (reader-averaged FOM, 0.887 vs. 0.874, respectively; p = 0.581). Conclusion: Overall image quality and detectability of focal liver lesions is preserved in contrast-enhanced abdominopelvic LDCT obtained with DLIR-M relative to those in SDCT with h-IR.

A Pathological Survey on Liver Lesion of Slaughtered Native Cattle with Special Reference to Fascioliasis (한우(韓牛)의 도축검사례(屠畜檢査例)에 의한 간병변조사(肝病變調査) : 특히 간질증병변(肝蛭症病變)에 관하여)

  • Joh, Tae-Sun;Park, Bong-Joh;Kang, Su-Wha;Bak, Ung-Bok
    • Korean Journal of Veterinary Research
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    • v.16 no.1
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    • pp.35-44
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    • 1976
  • The livers of 300 cases of Korean native cattle which were collected at slaughted house in Pusan were examined by gross and histopathological means to study patterns of pathological changes of the organ. 1. The most dominated lesion of the liver was those of fascioliasis showing incidence rate as 907 per cent of inspected cattle. 2. On age distribution of the fascioliasis lesion in the liver, higher incidence was seen in animals that were from 6 to 9 years of age. 3. Significant changes of the hepaticparenchyma caused by immature flukes included thrombosis, migrational tracks such as hemorrhagic foci with massive eosinophilia and hepatic necrosis. The changes of chronically infected livers of cattle were recognized as proliferation of periductal eosinophilic granuloma of various degrees in each portal triad. And this easential cholangiohepatitis might develop into multiple focal cirrhosis or diffuse perilobular cirrhosis. 4. Most cases with gross lesion of swelled bile ducts on visceral surface of the liver showed histological evidences of fascioliasis lesion throughout hepatic lobes.

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Changing Role of Nuclear Medicine for the Evaluation of Focal Hepatic Tumors: From Lesion Detection to Tissue Characterization (국소 간 종양의 조직적 특성을 평가하는데 있어 최근 핵의학의 역할)

  • Kim, Chun-Ki;Yu, Mi-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.211-224
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    • 1998
  • The role of scintigraphic imaging has moved from the detection of lesions to the tissue-specific characterization of lesions over the past 2 decades. Major advances in nuclear medicine imaging include: 1) positron imaging, 2) improved instrumentation, such as the use of multidetector (dual or triple head) gamma cameras for single photon emission computed tomography, and 3) development of numerous new radiopharmaceuticals for positron or single photon imaging (labeled glucose analogue, amino acids, fatty acids, hormones, drugs, receptor ligands, monoclonal antibodies, etc). These advances have resulted in a significantly improved efficacy of radionuclide techniques for the evaluation of various tumors, including those within the liver. The current role of nuclear medicine in the evaluation of focal hepatic tumors is reviewed in this article with an emphasis on the clinical applications of various tracer studies and imaging findings.

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Radiologic Findings of Local Effect of Right Adrenal Pheochromocytoma on the Adjacent Liver: A Case Report (우측 부신에서 발생한 갈색세포종이 인접 간에 미치는 국소적 영향에 관한 영상의학적 소견 : 증례 보고)

  • Rhim, Jung-Hyo;Cho, Jeong-Yeon;Kim, Seung-Hyup
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.173-176
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    • 2012
  • We report the radiological findings of regional enhancement of the liver adjacent to the right adrenal pheochromocytoma. CT and MRI showed focal strong enhancement of adjacent liver tissue in the arterial phase. However during the delayed phase, the lesion showed iso-attenuation with normal hepatic parenchyma and not delineated. The lesion did not show abnormal signal intensity on neither T1 nor T2 weighted images and indistinguishable from normal parenchyma. The enhancing hepatic lesion was spontaneously regressed on postoperative follow up CT which was taken several months after the adrenalectomy.

Characterization of focal hepatic lesions with ferucarbotran (Resovist)-enhanced T2 and T2*-weighted MR imaging

  • 조은석;유정식
    • Proceedings of the KSMRM Conference
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    • 2003.10a
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    • pp.40-40
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    • 2003
  • The purpose of this study was to characterize focal hepatic lesions through pre and post ferucarbotran-enhanced T2 and T2*-weighted imaging and to help differentiate benign and malignant lesions 대상 및 방법: Consecutive 34 patients with 52 hepatic lesions underwent MRI before and after intravenous bolus injection of ferucarbotran (Resovist Sobering, Berlin, Germany) for evaluation of focal hepatic lesions. Lesions included hemangiomas (n=17), metastases (n=12), cysts (n=10), hepatocellular carcinomas (n=8), dysplastic nodules (n=4), and focal fat deposit (n=1). T2-weighted fast spin echo (TR/TE: 4060/138) and gradient echo T2*-weighted images(TR/TE: 140/5.3, FA = 90) were obtained according to the institutional routine imaging protocol. Lesional signal-intensity and lesion-to-liver contrast changes were measured by contrast-to-noise ratio (CNR) from region of interest.

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Comparison of In-Phase and Opposed-Phase FMPSPGR Images in Breath-hold T1-weighted MR IMaging of Liver (호흡정지 T1 강조 간 자기공명영상에서 동위상 역위상 FMPSPGR 영상의 비교)

  • 김명진;김만득;정재준;이종태;유형식
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.142-147
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    • 1997
  • Purpose: To compare the effectiveness of the in-phase (IP) sequence and the opposed-phase (Op) sequence in the detection of focal hepatic lesions in the single breath-hold hepatic MR imaging with fast gradient T1-weighted pulse sequences. Materials and Methods: IP and OP T1-weighted breath-hold imaging was performed using fast gradient echo sequences in 45 patients referred for known focal hepatic lesions, in which 78 lesions were detected. Three blind readers independently reviewed the images for lesion detectability. The signal-to-noise ratio (SNR) of the liver, the lesion-to-liver contrast-to-noise ratio (CNR) and the liver-to-spleen CNR were also compared. A consensus was reached by three readers to determine which sequence is better in image quality. Results: On OP images, 61(78%), 61(78%), and 63(89%) lesions were correctly identified for reader 1, 2 and 3, respectively. On IP images, 66(85%), 65(83%), and 65(93%) lesions were detected for each reader, respectively. When two image sets were combined, 71(91 %), 69(88 %), and 76(97%) lesions respectively were detected for each reader. In cases of hepatocellular carcinoma, liver-to-Iesion CNR was greater on the OP images(p (0.05), but in other lesions significant difference was not demonstrated. Liver-to-spleen CNR was higher on OP images(p ( 0.1), but the SNR of the liver was higher on the IP images. Conclusion: Use of both IP and OP imaging can be helpful to avoid erroneous missing of some focal hepatic lesions.

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