共查询到20条相似文献,搜索用时 46 毫秒
1.
Hettinger M Klotz M Bolay L Weber P 《Ultraschall in der Medizin (Stuttgart, Germany : 1980)》2005,26(2):150-153
Multiple bile duct hamartomas of the liver (von Meyenburg complex) are mostly incidental findings at autopsy. The 79-year-old female patient was presented to us with a superinfected Paget lesion of the right nipple. Ultrasound examination of the liver revealed multiple scattered hyperechoic lesions as well as some anechoic lesions, suspicious of metastatic disease. Computed tomography showed multiple focal lesions. The ultrasound-guided needle biopsy of the liver revealed multiple benign bile duct hamartamas. Magnetic resonance imaging ruled out diffuse malignant infiltration of the liver. 相似文献
2.
We present two rare cases of multifocal hepatic steatosis as a variant of fatty liver. Multifocal hepatic steatosis can cause
misleading findings in the differential diagnosis when using ultrasound and computed tomography. This case report describes
the atypical findings of focal fatty liver infiltrations, which were misdiagnosed as diffuse metastatic disease. The correct
diagnosis was established with magnetic resonance imaging using T1-weighted gradient-echo and T2-weighted Turbo spin-echo
sequences with spectral fat suppression. Multifocal hepatic steatosis was proven by biopsy.
Received: 28 December 2001/Accepted: 30 January 2002 相似文献
3.
Transjugular liver biopsy: modified Ross transseptal needle versus Quick-core biopsy needle 总被引:2,自引:0,他引:2
Background: We evaluated the differences in sample adequacy and safety between a transseptal needle and Quick-core biopsy needle for
transjugular liver biopsy.
Methods: Eighteen consecutive patients who had a bleeding diatheses and/or ascites underwent transjugular liver biopsy using a transseptal
needle (11 patients) and Quick-core biopsy needle (seven patients). The length of the specimens was measured before fixation.
A pathologist reviewed histologic slides for sample adequacy and pathologic diagnoses. Clinical records were reviewed for
complication.
Results: In all patients, liver biopsy was successful. A total of 45 specimens were obtained, with an average of 2.5 passes per patient.
The length of specimen was significantly longer with the Quick-core biopsy needle than with the transseptal needle (p < 0.05). Biopsied tissue was fragmented in 17 of 25 specimens with the transseptal needle but not fragmented in any specimen
with the Quick-core biopsy needle. All specimens were determined to be adequate except one with the transseptal needle. There
was no early or delayed complication in any patient.
Conclusion: Transjugular liver biopsy is a safe and effective procedure without any significant difference in complication and adequacy
when using a transseptal needle or Quick-core biopsy needle. Larger specimens can be obtained without tissue fragmentation
with the Quick-core biopsy needle.
Received: 30 August 1999/Revision accepted: 26 January 2000 相似文献
4.
Focal nodular hyperplasia of the liver: serial MRI with Gd-DOTA,superparamagnetic iron oxide,and Gd-EOB-DTPA 总被引:2,自引:0,他引:2
Background: To demonstrate the improved specificity of liver MRI in diagnosis of focal nodular hyperplasia (FNH) using liver specific
contrast agents.
Methods: In a patient after resected adenosarcoma of the uterus a focal nodular hyperplasia was followed. Serial MRI of the liver
was performed using first Gd-DOTA, followed by superparamagnetic iron oxide (SPIO) as well as Gd-EOB-DTPA.
Results: During the follow-up of FNH specificity of liver MRI improved using liver specific contrast agents. The central scar as well
as the pseudocapsule showed different typical contrast uptake using all three methods.
Conclusion: Serial MRI of the liver with Gd-DOTA, SPIO and Gd-EOB-DTPA can exclude a malignant liver lesion. Liver biopsy of FNH can
be avoided with increased specificity of MRI for FNH.
Received: 15 December 1995/Accepted: 17 January 1996 相似文献
5.
A. Uno H. Ishida K. Konno Y. Ohnami H. Naganuma M. Niizawa Y. Hamashima O. Masamune 《Abdominal imaging》1997,22(1):72-78
Portal hypertension is a relatively uncommon pathologic condition in children and young adults in contrast with older adults.
The aim of this study is to evaluate the utility of sonography and color Doppler sonography in the diagnosis of portal hypertension
in children and young patients and to evaluate the sonographic pattern of each disease. We reviewed 25 such patients who were
younger than 30 years old and obtained the following sonographic findings: (1) liver cirrhosis: (a) multiple intrahepatic
venovenous shunts in patients with primary Budd-Chiari syndrome and (b) intrahepatic vascular narrowing and nodular coarse
parenchymal texture, with multiple very-high-echo spots along the portal vein in patients with Wilson disease; (2) congenital
hepatic fibrosis: marked and developed collaterals, wide periportal echogenic band, and a heterogeneous parenchymal texture
comprised of multiple high echoes but without portal thrombus; and (3) extrahepatic portal thrombosis: invisible portal lumen
except as an echogenic band. Sonography and color Doppler sonography are very useful in diagnosing these portal hypertensive
diseases. However, there are no specific sonographic findings, and the role of sonography is limited to follow-up observation
of associated secondary hepatobiliary changes in patients with congenital biliary atresia.
Received: 1 May 1995/Accepted: 24 June 1995 相似文献
6.
To evaluate the imaging findings of biliary hamartomas (von Meyenburg complexes, vMCs) and discuss their differential diagnosis
from other related diseases, imaging findings of biliary hamartomas on ultrasonography (US), computed tomography (CT), magnetic
resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), and hepatobiliary scintigraphy were prospectively
analyzed in six patients. On ultrasound images, five of the six cases showed multiple small hyper- and hypoechoic lesions
with comet-tail echoes, especially when magnified using the zoom function. In all six cases, multiple tiny hypodense lesions
less than 10 mm in diameter were scattered throughout the liver with no enhancement on CT. These tiny lesions were demonstrated
to be hyper- and hypointense on T2- and TI-weighted images, respectively, in three patients who underwent MRI examinations.
MRCP was performed in two patients, and it clearly showed multiple tiny round and irregular-shaped hyperintense lesions. MRCP
and hepatobiliary scintigraphy showed normal appearances of intra- and extrahepatic bile ducts in two and one patients, respectively.
Imaging modalities are useful in the diagnosis and differential diagnosis of vMCs. A correct diagnosis might be obtained when
typical imaging findings present even without histological confirmation. 相似文献
7.
Intrahepatic splenosis: imaging features 总被引:1,自引:0,他引:1
De Vuysere S Van Steenbergen W Aerts R Van Hauwaert H Van Beckevoort D Van Hoe L 《Abdominal imaging》2000,25(2):187-189
We report a patient who presented with asymptomatic focal liver lesions and in whom a diagnosis of intrahepatic splenosis
was made. This rare condition mostly occurs in patients who previously underwent splenic trauma or surgery. Magnetic resonance
imaging (MRI) characteristics suggesting this diagnosis are described. The lesions were mainly hypointense on T1- and hyperintense
on T2-weighted images. After administration of small iron oxide particles (SPIO-Endorem), the lesions remained slightly hyperintense
relative to the hypointense liver parenchyma but showed a 50% loss in signal intensity. Knowledge of these MRI characteristics
may avoid the use of surgical interventions to arrive at the correct diagnosis of these rare liver lesions.
Received: 14 June 1999/Accepted: 14 July 1999 相似文献
8.
Nodular regenerative hyperplasia of the liver in Budd–Chiari syndrome: CT and MR features 总被引:1,自引:0,他引:1
We report the imaging findings of spiral computed tomography (CT), magnetic resonance (MR) imaging, and MR angiography in
a patient with nodular regenerative hyperplasia of the liver associated with Budd–Chiari syndrome. Spiral CT showed multiple
enhancing nodules during the hepatic arterial and portal venous phases. MR images showed multiple hyperintense nodules on
T1-weighted images and hypointense or isointense nodules on T2-weighted images. MR angiography showed thrombotic occlusion
of three hepatic veins, suggesting Budd–Chiari syndrome.
Received: 25 June 1999/Revision accepted: 22 September 1999 相似文献
9.
There are many causative diseases to produced portal vein thrombosis (PVT) with the most common being liver cirrhosis with
hepatocellular carcinoma. Visualization of abnormalities associated with PVT is crucial to diagnosis and appropriate intervention.
Dynamic contrast enhanced CT is the best means of diagnosis of PVT and evaluation of various causative diseases. The findings
of PVT of the dynamic CT are filling defect partially or totally occluding the vessel lumen and rim enhancement of the vessel
wall. Signs and symptoms of PVT may be subtle or nonspecific and overshadowed by the underlying illness. Radiologists should
be aware of the clinical situations that predispose a patient to portal or mesenteric vein thrombosis. 相似文献
10.
Small hepatocellular carcinoma: differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging 总被引:4,自引:0,他引:4
Background: To investigate the usefulness of color Doppler ultrasound (US) and dynamic Gd-DTPA-enhanced magnetic resonance (MR) imaging
in the differentiation of small hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH).
Methods: Thirty-eight small (3 cm or less) nodular lesions (in 38 cirrhotic patients) with US features consistent with HCC underwent
evaluation with color Doppler US and MR imaging. Breath-hold T1-weighted rapid acquisition spin echo MR sequence after bolus
injection of 0.1 mmol/kg gadopentetate dimeglumine was used to evaluate dynamic enhancement. US-guided tissue-core percutaneous
biopsy established the diagnosis: HCC in 28 cases and AH in 10.
Results: Color signals with pulsatile or continuous Doppler spectrum were demonstrated in 19 of 28 HCCs (68%) but in none of the AHs.
Although there was considerable overlap in signal intensity between HCC and AH on both unenhanced T1- and T2-weighted images,
early enhancement on breath-hold T1-weighted images obtained 40 s after starting contrast administration was observed in 22
of 28 HCCs (79%) but in none of the AHs. In 26 of 28 HCCs (93%), pulsatile or continuous flow at color Doppler US, early enhancement
at dynamic MR imaging, or both were observed.
Conclusion: Findings with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging enable a reliable distinction between small HCC and
AH.
Received: 8 August 1994/Accepted after revision: 27 January 1995 相似文献
11.
False-negative findings on CT angiography (CTA) in two patients with hepatocellular carcinoma (HCC) were demonstrated. CTA
images of one patient with an aberrant left hepatic artery branching from the left gastric artery and another patient whose
right hepatic artery was occluded owing to an unknown cause failed to demonstrate HCCs. This report suggests one of the diagnostic
pitfalls of CTA for diagnosis of liver tumors.
Received: 1 August 1995/Accepted: 12 September 1995 相似文献
12.
Background: To determine whether abnormal hepatic vein Doppler tracings can be used to predict liver transplantation rejection.
Methods: A total of 158 hepatic vein Doppler tracings were obtained on 93 postliver transplant patients (63 patients without rejection
and 30 patients with biopsy-proven rejection). Hepatic vein Doppler tracings were scored according to an established grading
system (0 = normal triphasic waveform, 1 = dampened waveform, with loss of flow reversal, 2 = completely flat waveform). The
hepatic vein Doppler tracings were then correlated with biopsy findings.
Results: In the group of 63 patients without rejection, 124 Doppler examinations were performed and graded as follows: 0 = 87 (70%),
1 = 31 (25%), and 2 = 6 (5%). In the group of 30 patients with biopsy-proven rejection, 34 Doppler examinations were performed
and graded as follows: 0 = 16 (47%), 1 = 14 (41%), and 2 = 4 (12%). The sensitivity of abnormal hepatic vein Doppler tracings
for detection of rejection was 53% and the specificity was 70%. The positive predictive value of an abnormal hepatic vein
Doppler tracing was 33% and the negative predictive value of a normal Doppler tracing was 84%.
Conclusions: Abnormal hepatic vein Doppler tracings are observed in patients with and without liver transplant rejection. Abnormal tracings
cannot be used to predict liver transplant rejection.
Received: 7 January 1997/Revision accepted: 17 April 1997 相似文献
13.
Xanthogranulomatous cholecystitis: a radiological study of 12 cases and a review of the literature 总被引:8,自引:0,他引:8
D. Casas R. Pérez-Andrés J. A. Jiménez A. Mariscal P. Cuadras M. Salas M. C. Gómez-Plaza 《Abdominal imaging》1996,21(5):456-460
Background: Twelve cases of xanthogranulomatous cholecystitis (XGC) are presented, and their radiologic appearance is described.
Methods: Four men and eight women, aged 31–82 years old, with XGC were reviewed. Abdominal ultrasound (US) was performed in all patients.
Computed tomography (CT) was performed in five patients, barium enema examination in two, and percutaneously CT-guided fine-needle
aspirative biopsy of the gallbladder in one.
Results: Barium enema examination showed an indentation of the hepatic flexure. Cholelithiasis was present in all patients, and sludge
was present in six. The gallbladder wall was thickened in all patients, irregular in nine, and could not be properly differentiated
from surrounding liver parenchyma or from other adjacent structures in most patients. A curvilinear halo, hypoechoic on US
and with low attenuation on CT, within the gallbladder wall was found in three patients and pericholecystic fluid in two others.
On CT, the pericholecystic fat had streaky soft tissue densities in three cases. Percutaneously CT-guided fine-needle aspirative
biopsy of the gallbladder was nondiagnostic. The diagnosis of gallbladder carcinoma was considered preoperatively in three
patients.
Conclusion: Despite the characteristic histologic appearance of XCG, radiologic findings are nonspecific, varying from signs observed
in other forms of cholecystitis to the appearance of a gallbladder neoplasm.
Received: 5 April 1995/Accepted: 15 May 1995 相似文献
14.
Fascioliasis: US, CT, and MRI findings with new observations 总被引:2,自引:0,他引:2
Kabaalioğlu A Cubuk M Senol U Cevikol C Karaali K Apaydin A Sindel T Lüleci E 《Abdominal imaging》2000,25(4):400-404
Background: The purpose of this study is to describe the ultrasonographic (US), computed tomographic (CT), and magnetic resonance imaging
(MRI) findings in fascioliasis and to emphasize the impact of radiology in diagnosis.
Methods: Radiologic findings in 23 consecutive patients with fascioliasis were prospectively recorded. All patients had at least one
US and CT examination, and 10 of them were studied by MRI. All diagnoses were confirmed by serologic methods. In the first
three cases, initial diagnosis was reached by microscopic demonstration of the parasites' eggs in bile obtained by US-guided
gallbladder aspiration.
Results: In the hepatic phase of fascioliasis, multiple, confluent, linear, tractlike, hypodense, nonenhancing hepatic lesions were
detected by CT. On US, the parasites could be clearly identified in the gallbladder or common bile duct as floating and nonshadowing
echogenic particles. MRI showed the lesions as hypo- or isointense on T1-weighted images and as hyperintense on T2-weighted
images.
Conclusions: CT findings in the hepatic phase and US findings in the biliary phase are characteristic of fascioliasis. Because clinical
and laboratory findings of fascioliasis may easily be confused with several diseases, radiologists should be familiar with
the specific radiologic findings of the disease to shorten the usual long-lasting diagnostic process.
Received: 15 December 1999/Accepted: 26 January 2000 相似文献
15.
Gabata T Matsui O Kadoya M Yoshikawa J Mitchell DG Ueda K Kawamori Y Takashima T 《Abdominal imaging》1999,24(2):153-156
Different imaging appearances of giant hyperplastic change of the caudate lobe of the liver are presented in a patient with liver cirrhosis. The mass like caudate lobe was isoechoic on ultrasound, hypodense on postcontrast computed tomography (CT), hyperintense on T1-weighted magnetic resonance, images and isointense on T2-weighted images. These imaging findings are similar to those of dysplastic nodule in cirrhotic liver. The caudate lobe received normal portal flow on CT during arterial portography, but superior mesenteric arteriography showed precocious or early division of the caudate portal branch. We suspect that caudate hyperplastic change may be correlated to anomalous caudate portal vein branch. 相似文献
16.
Venous return by the paraumbilical and hepatic veins in case of superior vena cava obstruction 总被引:2,自引:0,他引:2
Pseudolesion in segment IV of the liver is a well-known diagnostic pitfall during arterial portography or even spiral computed
tomography (CT) of the liver. It has suggested that this pseudolesion is the result of an abnormality in subsegmental perfusion.
We report a case of an early dense contrast enhancement of segment IV of the liver by epigastric and paraumbilical veins in
a patient with a superior vena cava obstruction. A pseudolesion in segment IV was observed in this patient on a spiral CT
of the liver obtained during the portal phase.
Received: 31 May 1995/Accepted: 6 July 1995 相似文献
17.
Background: Treatment of malignant pancreatic and/or biliary strictures requires tissue diagnosis. Since cytologic brushings at endoscopic
retrograde cholangiopancreatography (ERCP) of these strictures has a poor sensitivity for malignancy (30–83%) (see ME Ryan.
Gastrointestinal Endoscopy 1991;37(2):139–143; and MB Cohen, Wittchow RJ, Johlin FC, et al. Mod Pathol 1995;8:498–502), tissue diagnosis must be obtained by another route. We report our experience of percutaneous biopsy of malignant
pancreatic and/or biliary strictures even when no radiographic mass is present.
Methods: At ERCP, five patients demonstrated pancreatic and/or biliary duct strictures, had atypical cytological brushings, and had
their strictures stented. No mass to account for the strictures could be identified on CT. These five patients underwent percutaneous
biopsy of the peri-stent material by CT within 10 days of the ERCP.
Results: Two patients had adenocarcinoma of the pancreas. One patient had malignant lymphoma and another had cholangiocarcinoma. One
patient had inflammatory cells and was followed.
Conclusions: If the diagnosis of malignancy cannot be made at the time of the ERCP sampling, then our experience suggests that a percutaneous
biopsy should be performed even if a mass is not present using the stent as a target.
Received: 30 January 1996/Accepted: 28 March 1996 相似文献
18.
Intrahepatic venous collaterals 总被引:5,自引:0,他引:5
H. Naganuma H. Ishida K. Konno T. Komatsuda Y. Hamashima J. Ishida O. Masamune 《Abdominal imaging》1998,23(2):166-171
Background: The aim of this study was to reevaluate the causes and sites of intrahepatic venous collaterals and to determine the role
of color Doppler sonography in the diagnosis of this relatively rare vascular abnormality.
Methods: Real-time color Doppler sonography was used to study 21 patients with intrahepatic venous collaterals. The cause, distribution,
and clinical manifestations of collaterals were determined, and Doppler waveforms obtained from the collaterals were also
analyzed.
Results: First, the causes of intrahepatic venous collaterals were divided roughly into two groups according to the presence or absence
of veno-occlusions. The former group included liver tumors (six cases), primary Budd-Chiari syndrome (five cases), and metastatic
adrenal tumors invading the inferior vena cava (two cases). The latter group consisted of diaphragmatic hernia (three cases),
Osler-Weber-Rendu disease (two cases), and congestive liver (one case). The cause was not determined in two cases. Second,
venous collaterals were distributed throughout the entire liver in primary Budd-Chiari syndrome but localized in the other
cases. Third, Doppler waveforms of the collaterals were divided into two patterns: flat flow and multiphasic flow. Flat flow
pattern was seen in patients with veno-occlusive diseases, and multiphasic flow pattern was seen in patients without veno-occlusive
disease.
Conclusion: The relationship between intrahepatic venous collaterals and veno-occlusive diseases has been emphasized in the literature,
but the results of our series showed that they occurred under a wide variety of conditions, even without veno-occlusive diseases,
including diaphragmatic hernia and Osler-Weber-Rendu disease. The analysis of the Doppler waveforms of the collaterals was
useful in differentiating those due to veno-occlusive diseases and those not.
Received: 13 December 1996/Accepted: 22 January 1997 相似文献
19.
We present a patient with nodular regenerative hyperplasia of the liver (NRH) and portal vein absence studied with CT, MR
imaging, and MR angiography. The most striking feature was exuberant hemorrhoids due to a giant hepatofugal inferior mesenteric
vein. A relationship between unbalanced portal blood flow and nodular regenerative transformation of the liver is suggested
in this patient.
Received: 28 May 1996/Accepted: 10 July 1996 相似文献
20.
Primary malignant fibrous histiocytoma of the liver: imaging features of five surgically confirmed cases 总被引:9,自引:0,他引:9
Background: The purpose of the present study was to describe the various imaging features of primary malignant fibrous histiocytoma (MFH)
of the liver, a rare tumor of mesenchymal origin.
Methods: Sonography (n= 5), computed tomography (CT; n= 5), magnetic resonance (MR) imaging (n= 2), and hepatic arteriography (n= 3) in five patients who underwent partial hepatectomy for tumor resection were retrospectively reviewed and correlated with
pathologic findings.
Results: All tumors were clearly demarcated from surrounding hepatic parenchyma in sectional imaging with (n= 2) or without (n= 3) a fibrous capsule, which was pathologically verified. Internal architecture of abundant fibrosis, myxoid degeneration,
and/or hemorrhagic necrosis reflected the sonographic, CT and MR imaging findings. Marginal tumor staining without definite
tumor vasculature was the main feature of hepatic arteriography. There was no intratumoral calcification. All three tumors
involving the right lobe of the liver invaded the right hemidiaphragm.
Conclusion: Although there were no unique findings of primary hepatic MFH, a combined interpretation of various imaging modalities may
elucidate the malignant nature of the tumor.
Received: 20 May 1998/Accepted after revision: 1 July 1998 相似文献