Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment

Locoregional treatments,as alternatives to surgery,play a key role in the management of hepatocellular carcinoma(HCC).Liver magnetic resonance imaging(MRI)enables a multiparametric assessment,going beyond the traditional dynamic computed tomography approach.Moreover,the use of hepatobiliary agents can improve diagnostic accuracy and are becoming important in the diagnosis and follow-up of HCC.However,the main challenge is to quickly identify classical responses to loco-regional treatments in order to determine the most suitable management strategy for each patient.The aim of this review is to provide a summary of the most common and uncommon liver MRI findings in patients who underwent loco-regional treatments for HCC,with a special focus on ablative therapies(radiofrequency,microwaves and cryoablation),transarterial chemoembolization,trans-arterial radio-embolization and stereotactic ablative radiotherapy techniques,considering the usefulness of gadoxetate disodium(Gd-EOB-DTPA)contrast agent.

Benign focal liver lesions:The role of magnetic resonance imaging

Liver lesions are common findings in radiologists’daily routine.They are a complex category of pathology that range from solitary benign lesions to primary liver cancer and liver metastases.Benign focal liver lesions can arise from different liver cell types:Epithelial(hepatocytes and biliary cells)and nonepithelial(mesenchymal cells).Liver magnetic resonance imaging(MRI)is a fundamental radiological method in these patients as it allows with its multiparametric approach optimal non-invasive tissue characterization.Furthermore,advanced liver MRI techniques such as diffusion-weighted imaging and hepatobiliary contrast agents have improved the detection of focal liver lesions and can be highly effective in differentiating pseudotumor from tumors,as well as benign from malignant lesions,and can also be used for differential diagnosis.Although histological examination can be useful in making a definitive diagnosis,MRI is an important modality in the diagnosis of liver lesions with a significant impact on patient care.This aim of this review is to provide a comprehensive overview of benign liver lesions on MRI.

Cardiovascular magnetic resonance in myocardial infarction with non-obstructive coronary arteries patients: A review

The diagnosis of myocardial infarction with non-obstructive coronary arteries(MINOCA)necessitates documentation of an acute myocardial infarction(AMI),non-obstructive coronary arteries,using invasive coronary angiography or coronary computed tomography angiography and no clinically overt cause for AMI.Historically patients with MINOCA represent a clinical dilemma with subsequent uncertain clinical management.Differential diagnosis is crucial to choose the best therapeutic option for ischemic and non-ischemic MINOCA patients.Cardiovascular magnetic resonance(CMR)is able to analyze cardiac structure and function simultaneously and provides tissue characterization.Moreover,CMR could identify the cause of MINOCA in nearly two-third of patients providing valuable information for clinical decision making.Finally,it allows stratification of patients with worse outcomes which resulted in therapeutic changes in almost half of the patients.In this review we discuss the features of CMR in MINOCA;from exam protocols to imaging findings.

Cardiovascular magnetic resonance of cardiac tumors and masses

Cardiac masses diagnosis and treatment are a true challenge,although they are infrequently encountered in clinical practice.They encompass a broad set of lesions that include neoplastic(primary and secondary),non-neoplastic masses and pseudomasses.The clinical presentation of cardiac tumors is highly variable and depends on several factors such as size,location,relation with other structures and mobility.The presumptive diagnosis is made based on a preliminary non-invasive diagnostic work-up due to technical difficulties and risks associated with biopsy,which is still the diagnostic gold standard.The findings should always be interpreted in the clinical context to avoid misdiagnosis,particularly in specific conditions(e.g.,infective endocarditis or thrombi).The modern multi-modality imaging techniques has a key role not only for the initial assessment and differential diagnosis but also for management and surveillance of the cardiac masses.Cardiovascular magnetic resonance(CMR)allows an optimal non-invasive localization of the lesion,providing multiplanar information on its relation to surrounding structures.Moreover,with the additional feature of tissue characterization,CMR can be highly effective to distinguish pseudomasses from masses,as well as benign from malignant lesions,with further differential diagnosis of the latter.Although histopathological assessment is important to make a definitive diagnosis,CMR plays a key role in the diagnosis of suspected cardiac masses with a great impact on patient management.This literature review aims to provide a comprehensive overview of cardiac masses,from clinical and imaging protocol to pathological findings.