BACKGROUND:Large regenerative nodules (LRNs) are hyperplastic benign nodules most commonly associated with Budd-Chiari syndrome (BCS),caused by outflow obstruction of the hepatic veins or vena cava.To our knowledge,no...BACKGROUND:Large regenerative nodules (LRNs) are hyperplastic benign nodules most commonly associated with Budd-Chiari syndrome (BCS),caused by outflow obstruction of the hepatic veins or vena cava.To our knowledge,no cases of LRNs arising in BCS after transjugular intrahepatic portosystemic shunt (TIPS) positioning and detected by GdEOB-DTPA MRI have been reported in the literature.METHODS:A 58-year-old woman with BCS,on the liver transplantation (LT) list,underwent a follow-up enhanced MRI.Two years earlier,a TIPS had been placed.In 2008,recurrent hepaticoencephalopathy resistant to medical treatment fulfilled the LT criteria for BCS treated with TIPS and the patient was therefore added to the LT list.CT performed before TIPS had not detected any hepatic lesions.CT performed six months after TIPS showed its complete patency but documented two indeterminate hypervascular liver lesions.RESULTS:MRI performed with Gd-EOB-DTPA revealed additional hypervascular lesions with uptake and retention of the medium in the hepatobiliary phase,thus reflecting a benign behavior of hepatocellular composition.These MRI features were related to LRNs as confirmed by histopathologic analysis.CONCLUSIONS:Gd-EOB-DTPA-enhanced MRI is potentially superior to standard imaging using gadolinium chelates or spiral CT,especially for the differential diagnosis of hypervascular lesions.Gd-EOB-DTPA MRI may become the imaging method of choice for evaluating LT list patients with BCS after TIPS placement.展开更多
Liver cancer is the common malignant tumor in China and current treatment is based on surgery. However, liver function of many liver cancer patients is impaired before surgery, so there’s a high possibility of occurr...Liver cancer is the common malignant tumor in China and current treatment is based on surgery. However, liver function of many liver cancer patients is impaired before surgery, so there’s a high possibility of occurrence of liver failure after the tumor resection. Therefore, it’s necessary to accurately evaluate liver function before surgery. Currently, clinical methods are mostly limited to assess the function of overall liver. But the application of hepatocyte-specific contrast agent—gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) makes it possible to assess the function of local liver segment accurately. This paper reviewed the progress of using Gd-EOB-DTPA dynamic contrast enhanced magnetic resonance imaging (MRI) to assess liver function preoperatively, such as parameters selection for liver function assessment, clinical factors affecting Gd-EOB-DTPA enhanced MRI and so on.展开更多
文摘BACKGROUND:Large regenerative nodules (LRNs) are hyperplastic benign nodules most commonly associated with Budd-Chiari syndrome (BCS),caused by outflow obstruction of the hepatic veins or vena cava.To our knowledge,no cases of LRNs arising in BCS after transjugular intrahepatic portosystemic shunt (TIPS) positioning and detected by GdEOB-DTPA MRI have been reported in the literature.METHODS:A 58-year-old woman with BCS,on the liver transplantation (LT) list,underwent a follow-up enhanced MRI.Two years earlier,a TIPS had been placed.In 2008,recurrent hepaticoencephalopathy resistant to medical treatment fulfilled the LT criteria for BCS treated with TIPS and the patient was therefore added to the LT list.CT performed before TIPS had not detected any hepatic lesions.CT performed six months after TIPS showed its complete patency but documented two indeterminate hypervascular liver lesions.RESULTS:MRI performed with Gd-EOB-DTPA revealed additional hypervascular lesions with uptake and retention of the medium in the hepatobiliary phase,thus reflecting a benign behavior of hepatocellular composition.These MRI features were related to LRNs as confirmed by histopathologic analysis.CONCLUSIONS:Gd-EOB-DTPA-enhanced MRI is potentially superior to standard imaging using gadolinium chelates or spiral CT,especially for the differential diagnosis of hypervascular lesions.Gd-EOB-DTPA MRI may become the imaging method of choice for evaluating LT list patients with BCS after TIPS placement.
文摘Liver cancer is the common malignant tumor in China and current treatment is based on surgery. However, liver function of many liver cancer patients is impaired before surgery, so there’s a high possibility of occurrence of liver failure after the tumor resection. Therefore, it’s necessary to accurately evaluate liver function before surgery. Currently, clinical methods are mostly limited to assess the function of overall liver. But the application of hepatocyte-specific contrast agent—gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) makes it possible to assess the function of local liver segment accurately. This paper reviewed the progress of using Gd-EOB-DTPA dynamic contrast enhanced magnetic resonance imaging (MRI) to assess liver function preoperatively, such as parameters selection for liver function assessment, clinical factors affecting Gd-EOB-DTPA enhanced MRI and so on.
