Hepatocarcinoma fibrolamelar un tumor de adultos jóvenes poco frecuente. . Dentro de los diagnósticos diferenciales se debe considerar la HNF, CHC. Protocolo de diagnóstico diferencial de las lesiones ocupantes de espacio en el hígado cirrótico Clinical management of hepatocellular carcinoma. Su diagnóstico suele ser tardío, ya que se presenta en pacientes jóvenes, sin . a las del hepatocarcinoma en la que es necesario un diagnóstico diferencial.
|Published (Last):||11 December 2012|
|PDF File Size:||13.44 Mb|
|ePub File Size:||3.61 Mb|
|Price:||Free* [*Free Regsitration Required]|
The presence of intralesional fat and the absence of hepatobiliary contrast uptake indicate a probable diagnosis of adenoma. Imaging findings in the hepatobiliary findings should be always analyzed in the clinical context, considering diagnostic lesion signal characteristics on anatomical sequences.
Case reports in oncology ; 5 1: Additionally, as compared with healthy livers, cirrhotic livers present later enhancement peak and slower washout 32 – Thus, high-grade dysplastic nodules tend to be hypovascular in the arterial and portal phases, but may also become difetencial in the arterial phase in cases where the abnormal arterial vascularization hrpatocarcinoma more developed.
Perfusional alterations present a signal similar to the one of the remainder hepatic tissue during the portal and hepatobiliary phases, while most HCCs, except the well-differentiated ones, present hyposignal in the hepatobiliary phase The usual dynamic study with arterial, portal and delayed phases is also performed with such contrast agents.
Case Report of Fibrolamellar Hepatocarcinoma, a Rare Tumor of Young Adults
The biliary excretion of hepatobiliary contrast agents allows for the anatomical and functional characterization of intra- and extrahepatic biliary tract. Low-grade regenerative and dysplastic nodules present preferentially portal vascularization, contain functioning hepatocytes and, like the surrounding parenchyma, show hepatobiliary contrast uptake. However, MRI does not allow for the diagnosis in all cases whose etiology remains undetermined.
Hemangiomas present the same imaging findings at dynamic studies with hepatobiliary contrast; however, in the delayed phase, as the hepatobiliary contrast medium is leaving the interstitium and entering into the functioning hepatocytes, the hemangioma fill-in might or might not occur in this phase, differing from its usual behavior with the use of extracellular gadolinium However, considering that hemangiomas are common lesions, they will be frequently present on images acquired with hepatobiliary contrast for several reasons.
Two hypervascular lesions arrows are seen with intermediate signal hepatocarfinoma on T1- and T2- weighted sequences, showing contrast uptake in diagjostico hepatobiliary-phase. Hemangiomas do not contain functioning hepatocytes so uptake of this contrast medium is not observed.
Such lesions present functioning hepatocytes, suggesting FNHs as the main diagnostic hypothesis and ruling out the possibility of metastatic implants. Cancer ; 46 2: MR imaging eiagnostico hypervascular lesions in the cirrhotic liver: Adenomas are composed of hepatocytes containing glycogen and lipids surrounded by a capsule.
No hepatobiliary contrast uptake is observed. A potential confusion factor is the fact that some hemangiomas may present subtle central contrast uptake during the early hepatobiliary phase because of the tendency to persistent centripetal enhancement at dynamic study, like in those with extracellular gadolinium 1.
Rarely, there is hepatobiliary contrast uptake by adenomas and, in cases where it occurs, such an uptake tends to be preferentially peripheral in the hepatobiliary phase 124.
Cecil Tratado de medicina interna. Advances in anatomic pathology ; 14 3: Several studies are evaluating the relation between the degree of hepatic fibrosis heaptocarcinoma patients with cirrhosis As well as the hepatobiliary contrast enhancement with the objective of reducing the necessity of biopsies currently considered a gold standard.
The characterization of focal liver lesions is very important.
The previous knowledge of the biliary anatomy and its variations becomes increasingly important in the preoperative planning, considering the complexity of the hepatic anatomy as well as of the more refined surgical techniques, which reduces the occurrence of postoperative complications 4. Imaging of fibrolamellar hepatocellular carcinoma.
There was a problem providing the content you requested
Support Center Support Center. Find articles by Daniella Braz Parente. Progres dans les recherches sur le cancer ; The hepatobiliary contrast may contribute to the diagnosis of cholecystitis as the gallbladder is not filled by the contrast medium, differently from its habitual behavior with other contrast agents. The imaging evaluation of the biliary system has been approached by a series of publications in the Brazilian radiological literature 24 – So, hepatobiliary contrast agents combine the pharmacodynamic features of extracellular gadolinium usual dynamic study with the delayed hepatobiliary phase, adding functional information to the MRI study and enhancing its diagnostic accuracy 124 – 6.
The diagnostic performance of MRI in the detection of HCCs of all sizes increases with the utilization of hepatobiliary contrast agents 1 The avascular lesion arrowhead is secondary to post-treatment alteration.