dimeglumine enhanced MRI.
|
|
- Annice Wright
- 6 years ago
- Views:
Transcription
1 Hepatobiliary Imaging Ricci et al. Sonography of Benign Liver Lesions Paolo Ricci 1 Andrea Laghi Vito Cantisani Pasquale Paolantonio Sara Pacella Elisa Pagliara Federico Arduini Valerio Pasqualini Francesca Trippa Marzia Filpo Roberto Passariello Ricci P, Laghi A, Cantisani V, et al. Received April 19, 2004; accepted after revision July 1, All authors: Dipartimento di Scienze Radiologiche, Policlinico Umberto I Università La Sapienza, V. le Regina Elena, Rome , Italy. Address correspondence to P. Ricci (paolo.ricci@uniroma1.it). AJR 2005;184: X/05/ American Roentgen Ray Society Original Report Contrast-Enhanced Sonography with SonoVue: Enhancement Patterns of Benign Focal Liver Lesions and Correlation with Dynamic Gadobenate Dimeglumine Enhanced MRI OBJECTIVE. Contrast-enhanced real-time low-mechanical-index sonography is a new diagnostic technique for the assessment of macro- and microcirculation. The purpose of our article is to describe contrast-enhancement patterns of different benign focal liver lesions using the second-generation contrast agent SonoVue and to compare these findings with those of gadobenate dimeglumine enhanced MRI. CONCLUSION. SonoVue-enhanced real-time low-mechanical-index sonography provides specific contrast-enhancement patterns of different benign focal liver lesions, allowing accurate characterization. Findings on SonoVue-enhanced sonography correlate well with those obtained on gadobenate dimeglumine enhanced MRI. haracterization of focal liver lesions still remains a challenge for C diagnostic radiology, the aim of which is to avoid invasive procedures (i.e., liver biopsy), especially for the diagnosis of benign lesions. Sonography, because it is safe, inexpensive, quick, and easily accessible, is the first-line imaging technique for liver evaluation. However, baseline sonographic examination has several limitations in lesion characterization, requiring the need for second-level diagnostic studies (helical CT, MRI) [1, 2]. Color Doppler sonography shows promises of better diagnostic performance with the analysis of Doppler sonography spectra in or around tumors, although artifacts represented by respiratory or cardiac activity limit the diagnostic accuracy [1, 3]. IV sonographic contrast agents, consisting of tiny microbubbles confined to intravascular spaces and not leaking through the vessel wall, can enhance Doppler sonography signals and overcome these limitations [4]. Although these contrast agents increase the reflectivity of blood and enhance spectral and color Doppler signals, even contrast-enhanced color Doppler sonography is associated with artifacts such as color blooming and oversaturation. Moreover, overlapping between color Doppler patterns of benign and malignant lesions has been shown [5]. Harmonic sonography is a new technique that uses microbubble contrast agents and produces fewer artifacts. Tanaka et al. [6] reported that the combination of Levovist (SH U 508A, Schering) and second harmonic imaging software (the so-called intermittent imaging) allows a dynamic sonography protocol with which the contrast-enhancement patterns of different liver lesions can be assessed. Recently, the development of second-generation contrast agents and dedicated software AJR:184, March
2 Ricci et al. allows real-time examination and easier definition of enhancement patterns [7 9]. These microbubble agents use insoluble gases such as sulfur hexafluoride or perfluoropropane to achieve better stabilization of microbubbles in vivo. Microbubbles can survive multiple capillary passages after IV injection, giving significant contrast enhancement in the left heart and the arterial system and in the venous system after the second capillary passage. The aim of our study was to evaluate the dynamic pattern of enhancement of real-time sonography using a second-generation contrast agent (SonoVue, Bracco) in a population of patients with focal liver lesions characterized as benign on gadobenate dimeglumine enhanced MRI. Sonographic findings of enhancing patterns were compared with findings of dynamic contrast-enhanced MRI performed after the IV injection of gadobenate dimeglumine. A Subjects and Methods Patient Population Between January and September 2003, we examined 43 patients (21 men, 22 women; median age, 55 years, range, years) who had focal liver lesions detected as benign on contrast-enhanced dynamic MRI, who could actively cooperate, and who required no sedation. Forty-eight lesions were detected: 27 hemangiomas (measuring cm in maximum diameter), 17 focal nodular hyperplasias (measuring cm in diameter), and four adenomas (measuring 2 5 cm in diameter). MRI was considered the gold standard for the diagnosis of hemangioma and focal nodular hyperplasia. Diagnostic criteria for hemangiomas were the combination of a markedly hyperintense signal on T2-weighted images; a specific contrast-enhancement pattern on dynamic studies, represented by globular enhancement during the arterial phase and progressive fill-in during B C D Fig year-old man with hepatic hemangioma. A and B, Contrast-enhanced sonograms show globular peripheral enhancement of lesion during arterial phase (A) and incomplete filling-in during portal and late phases (B). C and D, Gadobenate dimeglumine enhanced MR images show lesion presenting same contrast behavior. 822 AJR:184, March 2005
3 Sonography of Benign Liver Lesions the portal venous phase; and a hypointense signal on the hepatobiliary phase images. Diagnostic criteria for focal nodular hyperplasia were, first, an iso- or slightly hypointense signal on T1-weighted images and an iso- or slightly hyperintense signal on T2-weighted images and second, a dynamic contrast-enhancement pattern showing marked hypervascularity on the arterial phase with rapid washout and isointensity on portal venous and delayed phase images. In addition, hyperintensity compared with surrounding liver parenchyma on the hepatobiliary phase images was considered pathognomonic. In all four liver adenomas, sonographically guided biopsy was obtained for diagnostic confirmation. After the study was approved by the institutional review board, we obtained written consent from Fig year-old woman with focal nodular hyperplasia. A, Contrast-enhanced sonogram shows early homogeneous enhancement during arterial phase. B and C, Contrast-enhanced sonograms show lesion appears slightly hyperechoic and hysoechoic (having same enhancement as surrounding liver parenchyma in portal and late phases) during portal (B) and late (C) phases. (Fig. 2 continues on next page) each patient before contrast-enhanced sonography was performed. Sonography Protocol Patients were examined using an Esatune scanner (Esaote) equipped with dedicated software (CnTI Contrast Tuned Imaging, Esaote) and C530 convex or PA420 phased-array probes (Esaote). The sonographic examinations included conventional gray-scale imaging to identify anatomic landmarks and real-time low-mechanicalindex ( ) continuous scanning after the administration of a bolus of SonoVue. Contrastenhancement patterns were assessed twice during a 30-min interval. SonoVue was administered as an IV fast bolus of 2.4 ml, followed by 3 ml of saline flush. A single marker lesion was identified, measured, and evaluated. When more lesions were identified on conventional sonography, a single marker lesion, the larger and more conspicuous one, was considered for characterization. When different lesions revealed similar dimensions and conspicuity, the more superficial was selected. Patients with more lesions were evaluated on a lesion-by-lesion basis. During contrast-enhanced evaluations, the entire vascular phase was continuously studied, consisting of an arterial phase (15 45 sec after the injection), a portal venous phase (50 90 sec), and a late phase (90 sec to 4 5 min). Our scanning technique was stationary in the region of the lesion, allowing the visualization of macro- and microcirculation of the lesion, as a result of the blood pool characteristics of SonoVue. In some cases, we performed flash A B C AJR:184, March
4 Ricci et al. scanning (i.e., high-mechanical-index fast scanning), which allows microbubble destruction, to evaluate reperfusion during the arterial phase in lesions showing strong enhancement and during the portal phase only in lesions showing contrast enhancement during this phase. Reperfusion after flash scanning during the portal phase must be considered pathognomonic for focal nodular hyperplasia. All examinations were digitally recorded and subsequently analyzed off-line. MRI Protocol MRI was performed in all patients within 7 days before contrast-enhanced sonography with a 1.5-T MR unit (Magnetom Vision Plus; Siemens Medical D F Solutions) using a phased-array multicoil as a receiver coil. The MRI protocol included axial breath-hold T2-weighted (TR/TE, infinite/90; flip angle, 150 ; acquisiton time, 25 sec; slice thickness, 6 mm; interslice gap, 0.25%; matrix, ; field of view, 350 mm), half-fourier singleshot turbo spin-echo (HASTE), and unenhanced and gadobenate dimeglumine enhanced spoiled T1-weighted (TR/TE, 170/4.6; flip angle, 80 ; number of excitations, 1; acquisition time, 20 sec; slice thickness, 6 mm; interslice gap, 0.25%; matrix, ; field of view, 350 mm) fast low-angle shot (FLASH) sequences. A triphasic dynamic contrast-enhanced study was obtained after the administration of an IV bolus of 0.1 mmol/kg of gadobenate dimeglumine (MultiHance, Bracco) Fig. 2. (continued) 28-year-old woman with focal nodular hyperplasia. D and E, Gadobenate dimeglumine enhanced MR images reveal that lesion appears markedly hyperintense during arterial phase (D) and hysointense during portal (E) and late phases. F, Gadobenate dimeglumine enhanced MR image after 1 hr (hepatobiliary phase) shows that lesions remain isointense compared with liver parenchyma. flushed by 20 ml of sterile saline solution using an automatic MR-compatible injector. The scanning delay for triphasic dynamic gradient-recalled echo imaging was 14 sec, 50 sec, and 3 min after initiating contrast injection, representing the hepatic arterial, portal venous, and equilibrium phases, respectively. The dynamic study was followed by a delayed, hepatospecific phase obtained 1 hr after the injection of contrast material, as recommended by the manufacturer. Previous studies have shown that liver enhancement with gadobenate dimeglumine is relatively stable during this period [10]. Image Analysis Sonographic digital records were analyzed offline, in consensus, by two radiologists who were E 824 AJR:184, March 2005
5 Sonography of Benign Liver Lesions both experienced in contrast sonography of the liver and who were blinded to clinical and other imaging data. MR images were reviewed by two gastrointestinal radiologists experienced in both liver sonography and MRI. Images were analyzed at different consensus conferences to describe size, baseline appearance, and dynamic contrast-enhancement behavior of the different lesions. Sonographic findings were eventually compared with MRI findings Results All lesions were successfully studied during the arterial, portal, and late phases on both sonography and MRI. No clinically significant side effects related to the sonographic contrast agent were experienced by patients. No patients were excluded from the study because of the inability to cooperate, and the studies were considered to be of sufficient diagnostic quality in all cases. Hemangioma Twenty-seven hemangiomas were detected in 24 patients. On baseline sonography, all the hemangiomas were inhomogeneous with posterior acoustic enhancement: Fifteen were hyperechoic, three hyper- and isoechoic, and nine hypoechoic. The contrast-enhancement patterns were as follows: specific globular enhancement (Fig. 1A) with progressive complete (n = 12) and incomplete (n = 13) (Fig. 1B) wash-in in 25 lesions. In the remaining two lesions, a rapid wash-in, with late washout, characteristic of a capillary hemangioma, was observed. On unenhanced MRI, all the lesions were hypointense on T1-weighted and markedly hyperintense on T2-weighted images. On contrast-enhanced studies, 25 lesions showed a globular enhancement pattern during the arterial phase (Fig. 1C) with progressive centripetal filling (complete in 12 lesions and incomplete in 13 [Fig. 1D]) during the portal venous and equilibrium phases. During the 1-hr hepatobiliary phase, all lesions showed a hypointense signal compared with liver parenchyma. In the remaining two lesions, characterized as capillary hemangiomas, the contrast-enhancement pattern presented rapid wash-in during the arterial phase, with persistent enhancement during the portal venous and equilibrium phases. Hypointense signal compared with surrounding liver parenchyma was observed during the hepatobiliary phase. Dynamic enhancement patterns on MRI completely correlated with those on contrast-enhanced sonography. Focal Nodular Hyperplasia Seventeen focal nodular hyperplasias were detected in 15 asymptomatic women with no history of chronic hepatic disease. On baseline sonography, the lesions appeared slightly hyperechoic, with evidence of a central hypoechoic area in seven cases. During the contrast-enhanced study, the lesions showed an extremely rapid homogeneous contrast uptake during the arterial phase (Fig. 2A), with mild hyperechogenicity or isoechogenicity relative to surrounding enhanced liver parenchyma during the portal and late phases (Figs. 2B and 2C). A central scar was evident on the portal and late phases in seven cases. A specific diagnostic clue in the characterization of focal nodular hyperplasia was the evidence of revascularization during the portal and late phases after microbubble disruption as a result of the flash scanning application. On unenhanced MRI, all the lesions were isointense on T1-weighted images and iso- to slightly hyperintense on T2-weighted images. MR images showed homogeneous contrast enhancement during the arterial phase (Fig. 2D), with isointensity during the portal (Fig. 2E) and equilibrium phases. During the 1-hr hepatobiliary phase, all lesions showed isointense to slightly hyperintense signal compared with liver parenchyma (Fig. 2F). A central scar (hyperintense on both the T2- weighted images and on the portal and late phases of contrast-enhanced T1-weighted images) was observed in five cases. A B Fig year-old woman with hepatocellular adenoma. A and B, Contrast-enhanced sonograms show early, intense, and homogeneous wash-in during arterial phase (A) followed by fast washout during portal phase (B). (Fig. 3 continues on next page) AJR:184, March
6 Ricci et al. Fig. 3. (continued) 40-year-old woman with hepatocellular adenoma. C and D, Gadobenate dimeglumine enhanced MR images show same contrast behavior during arterial (C) and portal (D) phases. Arrow indicates lesion. E, Gadobenate dimeglumine enhanced MR image after 1 hr (hepatobiliary phase) shows lesions (arrow) appear hypointense compared with liver parenchyma. Adenoma Four adenomas were evaluated in four women with histories of chronic use of oral contraceptives. All four lesions appeared as rounded, iso- to hyperechoic lesions. All lesions were characterized by early homogeneous contrast enhancement during the arterial phase (Fig. 3A), with subsequent rapid washout during the portal phase (Fig. 3B). On unenhanced examination, the lesions were hypointense on T1-weighted images and slightly hyperintense on T2-weighted images. MR images showed homogeneous and intense contrast enhancement during the arterial phase (Fig. 3C), with rapid washout during the portal venous and equilibrium phases C D (Fig. 3D) and no evidence of either a central scar or a pseudocapsule. During the 1-hr hepatobiliary phase, all lesions showed a hypointense signal compared with liver parenchyma. Dynamic MRI findings correlated well with contrast-enhanced sonographic features in all patients (Fig. 3E). Discussion SonoVue is a new blood pool sonographic contrast agent that consists of a stabilized aqueous suspension of sulfur hexafluoride microbubbles with a phospholipidic shell. The mean diameter of SonoVue bubbles is 2.5 mm, which allows both transpulmonary and transinusoidal passage. These bubbles have a strong wideband harmonic response at low mechanical index, which is ideal for vascular phase imaging, allowing clear depiction of the arterial, portal, and late phases and visualization of both macro- and microvasculature of hepatic lesions. Unlike CT or MRI contrast agents, which diffuse into the extravascular space to enter the equilibrium phase, Sono- Vue is a blood pool agent and therefore does not have a true equilibrium phase. Scans are obtained by either moving the transducer over the entire liver to visualize the vascular phases in real-time or remaining in the region of interest to study the changes of enhancement over time in that area. To date only few reports have been published on the clinical E 826 AJR:184, March 2005
7 Sonography of Benign Liver Lesions use of contrast-enhanced sonography with SonoVue in characterization of focal liver lesions [7 9]. Leen et al. [7] showed that the administration of SonoVue improves the Doppler display of tumoral vascularization with reduced interobserver variability and is a useful tool in characterization of focal liver lesions. Quaia et al. [8, 11] and Hohmann et al. [9] reported that low-mechanical-index real-time sonography with SonoVue markedly improves the characterization of focal hepatic lesions in comparison with unenhanced sonography. As shown in our study, contrast-enhanced sonography is useful in providing specific contrast-enhancement patterns during realtime evaluation of liver lesions, without any risk of missing the optimal phase of observation. This is equivalent to MRI, but at a lower cost and with better patient compliance. Regarding hemangiomas, a typical feature is evidence of globular enhancement, with progressive in-filling, which was observed in 25 of our patients. This is particularly useful in the presence of atypical hemangiomas, which appear on baseline examinations as hypo- or hysoechoic (having the same echogenicity as the surrounding liver parenchyma, commonly with a thin hypoechoic peripheral rim) lesions, as seen in our study in nine patients. However, when a different contrast behavior during the arterial phase was observed, the detection of late washout led to the diagnosis of capillary hemangioma [12]. Focal nodular hyperplasias showed an early strong and homogeneous enhancement during the arterial phase. During the portal phase, the lesions appeared mildly hyperechoic over the normal parenchyma because of their portal supply, whereas the lesions appeared hysoechoic (having the same enhancement as the surrounding enhanced liver parenchyma in the late phase) during the late phase. Key points in the characterization of focal nodular hyperplasias are early and homogeneous enhancement during the arterial phase, presence of portal supply, evidence of a hypoechoic scar, and lack of a pseudocapsule. These features are helpful in differentiating focal nodular hyperplasia from hepatocellular carcinoma and adenoma. The association of a history of chronic use of oral contraceptives with the presence of a rounded and well-marginated lesion showing early homogeneous enhancement during the arterial phase and rapid washout during the portal phase may lead to the diagnosis of adenoma. An important point in differentiating adenoma from focal nodular hyperplasia is the absence of portal supply. A clue to discriminate hepatocellular carcinoma from adenoma is the slow and more heterogeneous arterial enhancement and the frequent presence of a pseudocapsule. All contrast-enhanced sonographic findings correlated well with those of MRI. As shown in our study, contrast-enhanced sonography with SonoVue is a useful tool in the characterization of focal liver lesions. This technique is characterized by high cost-effectiveness, high patient compliance, and high accuracy in providing specific contrast-enhancement patterns that are roughly comparable to those obtained on MRI. Although our study population was limited, especially regarding the few cases of adenomas and the absence of regenerative nodules, our results show that in the workup (follow-up and diagnosis) of patients with benign focal liver lesions, sonography should be performed with second-generation contrast agents and new technologies such as Contrast Tuned Imaging. References 1. Wilson SR, Burns PN, Muradali DM, Wilson JA, Lai X. Harmonic hepatic US with microbubble contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis. Radiology 2000;215: Ros PR, Mortele KJ. Hepatic imaging: an overview. Clin Liver Dis 2002;6: Leen E. The role of contrast-enhanced ultrasound in the characterization of focal liver lesions. Eur Radiol 2001;11 [suppl 3]:E27 E34 4. Tanaka S, Kitamra T, Yoshioka F, et al. Color Doppler sonography of hepatic tumors with a galactose-based contrast agent: correlation with angiographic findings. Ultrasound Med Biol 1995;21: Hosten N, Puls R, Bechstein WO, Felix R. Focal liver lesions: Doppler ultrasound. Eur Radiol 1999;9: Tanaka S, Ioka T, Oshikawa O, Hamada Y, Yoshioka F. Dynamic sonography of hepatic tumors. AJR 2001;177: Leen E, Angerson WJ, Yarmenitis S, et al. Multicentre clinical study evaluating the efficacy of SonoVue (BR1), a new ultrasound contrast agent in Doppler investigation of focal hepatic lesions. Eur J Radiol 2002;41: Quaia E, Bertolotto M, Calderanl L, Mosconi E, Mucelli RP. US characterization of focal hepatic lesions with intermittent high-acoustic-power mode and contrast material. Acad Radiol 2003;10: Hohmann J, Skrok J, Puls R, Albrecht T. Characterization of focal liver lesions with contrast-enhanced low MI real time ultrasound and SonoVue [in German]. Rofo 2003;175: Petersein J, Spinazzi A, Giovagnoni A. Focal liver lesions: evaluation of the efficacy of gadobenate dimeglumine in MR imaging a multicenter phase III clinical study. Radiology 2000;215: Quaia E, Degobbis F, Tona G, Mosconi E, Bertolotto M, Pozzi Mucelli R. Differential patterns of contrast enhancement in different focal liver lesions after injection of the microbubble US contrast agent SonoVue. Radiol Med (Torino) 2004;107: Vilgrain V, Boulos L, Vuillerme M-P, et al. Imaging of atypical hemangiomas of the liver with pathologic correlation. RadioGraphics 2000;20: AJR:184, March
RICCARDO LENCIONI,CLOTILDE DELLA PINA, LAURA CROCETTI,DANIA CIONI. Chapter 1
RICCARDO LENCIONI,CLOTILDE DELLA PINA, LAURA CROCETTI,DANIA CIONI Chapter 1 Impact of European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) Guidelines on the Use of Contrast
More informationThe Contribution of Contrast Enhanced Ultrasound for the characterization of benign liver lesions in clinical practice a monocentric experience
Original papers Med Ultrason 2012, Vol. 14, no. 4, 283-287 The Contribution of Contrast Enhanced Ultrasound for the characterization of benign liver lesions in clinical practice a monocentric experience
More informationEssentials of Clinical MR, 2 nd edition. 65. Benign Hepatic Masses
65. Benign Hepatic Masses Pulse sequences acquired for abdominal MRI typically consist of fast acquisition schemes such as single-shot turbo spin echo (i.e. HASTE) and gradient echo schemes such as FLASH
More informationEvaluation of contrast-enhanced ultrasound for diagnosis of dysplastic nodules with a focus of hepatocellular carcinoma in liver cirrhosis patients
Original Article Evaluation of contrast-enhanced ultrasound for diagnosis of dysplastic nodules with a focus of hepatocellular carcinoma in liver cirrhosis patients Wei Wu, Minhua Chen, Kun Yan, Yin Dai,
More informationMædica - a Journal of Clinical Medicine
Mædica - a Journal of Clinical Medicine ORIGINAL PAPERS How Often Hepatocellular Carcinoma Has a Typical Pattern in Contrast Enhanced Ultrasound? Alina MARTIE, MD; Ioan SPOREA, MD, PhD; Roxana SIRLI, MD,
More informationFocal Hepatic Lesions: Contrast- Enhancement Patterns at Pulse-Inversion Harmonic US using a Microbubble Contrast Agent
Focal Hepatic Lesions: Contrast- Enhancement Patterns at Pulse-Inversion Harmonic US using a Microbubble Contrast Agent Eun-A Kim, MD Kwon-Ha Yoon, MD Young Hwan Lee, MD Hye Won Kim, MD Seon Kwan Juhng,
More informationPseudo Washout Sign in High-Flow Hepatic Hemangioma on Gadoxetic Acid Contrast-Enhanced MRI Mimicking Hypervascular Tumor
Gastrointestinal Imaging Clinical Observations Doo et al. Pseudo Washout Sign on MRI of Hemangioma Gastrointestinal Imaging Clinical Observations Kyung Won Doo 1 Chang Hee Lee Jae Woong Choi Jongmee Lee
More information116 ( 3. 0 cm), 146 ( 3. 0 cm) 42 48 ; 48, 5 CT 38 (79. 2 %),, ;6 ;4 3 1. 5 cm, 1 2. 2 cm 27 (56. 0 %) ; 14 (29. 0 %) 2 4,17 1 2, 4, 42, 87. 5 %(42/ 48 ), ; CT, ; ; ; Early diagnosis of small hepatocellular
More informationAn Algorithm for the Diagnosis of Focal Liver Masses Using Microbubble Contrast-Enhanced Pulse-Inversion Sonography
lgorithm for Sonography of Focal Liver Masses Hepatobiliary Imaging Original Research D E M N E U T R Y L I M I G O F I N G Stephanie R. Wilson 1,2 Peter N. Burns 1,3 Wilson SR, Burns PN Keywords: contract
More informationFinancial Disclosure
Benign Liver Masses Adil Abdalla, MBBS Creighton University-CHI Health August 25, 2018 Financial Disclosure Nothing to disclose Financial Disclosure 1 Objectives To assess patients with benign liver tumors
More informationU ltrasonography (US) is reported to be the primary
401 LIVER Improved characterisation of histologically proven liver tumours by contrast enhanced ultrasonography during the portal venous and specific late phase of SHU 508A C F Dietrich, A Ignee, J Trojan,
More informationDifferentiation Between Benign and Malignant Hepatic Lesions
Article Differentiation Between Benign and Malignant Hepatic Lesions Utility of Color Stimulated Acoustic Emission With the Microbubble Contrast Agent Levovist Alexandra von Herbay, MD, Christoph Vogt,
More informationUltrasound contrast agents (USCA)
Ultrasound contrast agents (USCA) Jean-Yves Meuwly, MD, University Hospital Lausanne, Switzerland Ultrasound contrast agents Initially developed in order to enhance the Doppler signal Increase in signal
More informationModern liver imaging techniques - A new era in liver ultrasound
Modern liver imaging techniques - A new era in liver ultrasound Yuko Kono, M.D., Ph.D. Clinical Professor Departments of Medicine and Radiology University of California, San Diego San Diego, USA How to
More informationRadiology of hepatobiliary diseases
GI cycle - Lecture 14 436 Teams Radiology of hepatobiliary diseases Objectives 1. To Interpret plan x-ray radiograph of abdomen with common pathologies. 2. To know the common pathologies presentation.
More informationTechnological advancements improve the sensitivity of CEUS diagnostics
Technological advancements improve the sensitivity of CEUS diagnostics. Martegani, MD, L. iani, MD Department of Diagnostic Imaging, Valduce Hospital, Como, Italy Characterization with Ultrasound B C D
More informationFocal Hypoechoic Tumors of Fatty Liver
Article Focal Hypoechoic Tumors of Fatty Liver Characterization of Conventional and Contrast-Enhanced Ultrasonography Li-Ping Liu, MD, Bao-Wei Dong, MD, Xiao-Ling Yu, MD, Ping Liang, MD, Da-Kun Zhang,
More informationCT & MRI of Benign Liver Neoplasms Srinivasa R Prasad
CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad No financial disclosures Acknowledgements Many thanks to Drs. Heiken, Narra & Menias (MIR) Dr. Sahani (MGH) for sharing images Benign Liver Tumors:
More informationPurpose. Background. Purpose
Does diffusion-weighted imaging (DWI) add diagnostic confidence in discriminating between malignant and benign solid focal lesions if included in contrast-enhanced magnetic resonance imaging (MRI) of the
More informationContrast-enhanced Breast MRI RSSA 2013
Contrast-enhanced Breast MRI RSSA 2013 Prof. dr. Maurice van den Bosch University Medical Center Utrecht, the Netherlands Index 1) Breast cancer 2) Why MRI of the breast 3) Technique 4) Interpretation
More informationInnovations in HCC Imaging: MDCT/MRI
Innovations in HCC Imaging: MDCT/MRI Anthony E. Cheng, M.D. Cardinal MRI Center Cardinal Santos Medical Center, Wilson Street, San Juan Innovations in HCC Imaging: Goals/Objectives MDCT/MRI Learn the diagnostic
More informationImaging Features of Sclerosed Hemangioma
Sclerosed Hemangioma Abdominal Imaging Clinical Observations Deirdre J. Doyle 1 Korosh Khalili 1 Maha Guindi 2 Mostafa Atri 3 Doyle DJ, Khalili K, Guindi M, Atri M Keywords: abdominal imaging, CT, liver,
More informationRadiological Reasoning: Incidentally Discovered Liver Mass
AJR Integrative Imaging LIFELONG LEARNING FOR RADIOLOGY This Radiological Reasoning article is available for SAM credit and CME credits when completed with the additional educational material provided
More informationImaging techniques to characterize spleen involvement in patients with Hodgkin lymphoma
Imaging techniques to characterize spleen involvement in patients with Hodgkin lymphoma Marco Picardi, MD Ematologia, Azienda Ospedaliera Universitaria Federico II, Naples, Italy 5th International Workshop
More informationS th US Contrast
S3-1 Comparison of CEUS and CECT or CEMRI in Assessment of Tumor Vascularity and Response to Thermal Ablation in Patients with Hepatocellular Carcinoma: A Multi-centre Study in China Ming-De LU, 1 Xiao-Ling
More informationAims and objectives. Page 2 of 10
Diagnostic performance of automated breast volume scanner (ABVS) versus hand-held ultrasound (HHUS) as second look for breast lesions detected only on magnetic resonance imaging. Poster No.: C-1701 Congress:
More informationEvaluation of Liver Mass Lesions. American College of Gastroenterology 2013 Regional Postgraduate Course
Evaluation of Liver Mass Lesions American College of Gastroenterology 2013 Regional Postgraduate Course Lewis R. Roberts, MB ChB, PhD Division of Gastroenterology and Hepatology Mayo Clinic College of
More informationContrast-enhanced ultrasound (CEUS) of focal liver lesions. A useful, rapid and accessible tool.
Contrast-enhanced ultrasound (CEUS) of focal liver lesions. A useful, rapid and accessible tool. Poster No.: C-2329 Congress: ECR 2012 Type: Educational Exhibit Authors: S. Santamaria Jareño, J. Carrero
More informationThe UGent Institutional Repository is the electronic archiving and dissemination platform for
biblio.ugent.be The UGent Institutional Repository is the electronic archiving and dissemination platform for all UGent research publications. Ghent University has implemented a mandate stipulating that
More informationCharacterization of Renal Cell Carcinoma Using Agent Detection Imaging: Comparison with Gray-Scale US
Characterization of Renal Cell Carcinoma Using Agent Detection Imaging: Comparison with Gray-Scale US Byung Kwan Park, MD 1, 2 Seung Hyup Kim, MD 1 Hyuck Jae Choi, MD 1 Index terms: Contrast media Ultrasound
More informationCTA/MRA of Pediatric Hepatic Masses Radiology-Pathology Correlation
Acta Radiológica Portuguesa, Vol.XVIII, nº70, pág. 41-50, Abr.-Jun., 2006 CTA/MRA of Pediatric Hepatic Masses Radiology-Pathology Correlation Marilyn J. Siegel Mallinckrodt Institute of Radiology, Washington
More informationLIVER IMAGING TIPS IN VARIOUS MODALITIES. M.Vlychou, MD, PhD Assoc. Professor of Radiology University of Thessaly
LIVER IMAGING TIPS IN VARIOUS MODALITIES M.Vlychou, MD, PhD Assoc. Professor of Radiology University of Thessaly Hepatocellular carcinoma is a common malignancy for which prevention, screening, diagnosis,
More informationContrast-Enhanced Ultrasonograpic Findings in Pancreatic Tumors
Int. J. Med. Sci. 2008, 5 203 Short Research Communication International Journal of Medical Sciences ISSN 1449-1907 www.medsci.org 2008 5(4):203-208 Ivyspring International Publisher. All rights reserved
More informationDiagnostic Challenges and Pitfalls in MR Imaging with Hepatocyte-specific
Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. ABDOMINAL AND GASTROINTESTINAL
More informationEnhancements in Hepatobiliary Imaging:
Enhancements in Hepatobiliary Imaging: S. Channual 1, MD; A. Pahwa 2, MD; S. Raman 1, MD. 1 UCLA Medical Center, Department of Radiologic Sciences 2 Olive-View UCLA Medical Center, Department of Radiology
More informationUltrasound Contrast Imaging Research
Ultrasound Quarterly Vol. 19, No. 1, pp. 27 37 Ultrasound Contrast Imaging Research Michalakis Averkiou, Ph.D., Jeff Powers, Ph.D., Dan Skyba, Ph.D., Matthew Bruce, M.S., and Seth Jensen, M.S. Ultrasound
More informationAdele Taibbi, MD, Tommaso Vincenzo Bartolotta, MD, PhD, Domenica Matranga, MD, PhD, Massimo Midiri, MD, Roberto Lagalla, MD
ORIGINAL RESEARCH Splenic Hemangiomas Contrast-Enhanced Sonographic Findings Adele Taibbi, MD, Tommaso Vincenzo Bartolotta, MD, PhD, Domenica Matranga, MD, PhD, Massimo Midiri, MD, Roberto Lagalla, MD
More informationCommon Occurrence of Benign Liver Lesions in Patients With Newly Diagnosed Breast Cancer Investigated by MRI for Suspected Liver Metastases
JOURNAL OF MAGNETIC RESONANCE IMAGING 10:165 169 (1999) Original Research Common Occurrence of Benign Liver Lesions in Patients With Newly Diagnosed Breast Cancer Investigated by MRI for Suspected Liver
More informationNormal Sonographic Anatomy
hapter 2:The Liver DUNSTAN ABRAHAM Normal Sonographic Anatomy Homogeneous, echogenic texture (Figure 2-1) Measures approximately 15 cm in length and 10 12.5 cm anterior to posterior; measurement taken
More informationContrast Enhanced Ultrasound of Parenchymal Masses in Children
Contrast Enhanced Ultrasound of Parenchymal Masses in Children Sue C Kaste, DO On behalf of Beth McCarville, MD St. Jude Children s Research Hospital Memphis, TN Overview Share St. Jude experience with
More informationINTRODUCTION. Key Words: Contrast enhanced ultrasonography; Liver masses. ORiginal Article
Gut and Liver, Vol. 8, No. 3, May 2014, pp. 292-297 ORiginal Article Clinically Useful Diagnostic Tool of Contrast Enhanced Ultrasonography for Focal Liver Masses: Comparison to Computed Tomography and
More informationMRI features of Triple-negative breast cancer: our experience.
MRI features of Triple-negative breast cancer: our experience. Poster No.: C-1852 Congress: ECR 2013 Type: Scientific Exhibit Authors: V. Bertani, A. Gualano, V. Londero, A. Dal Col, M. Marcon, P. 1 2
More informationFactors associated with T2 Shine-Through Effect in Hepatic Hemangiomas on Diffusion-weighted MR Sequences
Factors associated with T Shine-Through Effect in Hepatic Hemangiomas on Diffusion-weighted MR Sequences Poster No.: C-09 Congress: ECR 014 Type: Scientific Exhibit Authors: R. Duran, M. Ronot, A. kerbaol,
More informationHEPATOCYTE SPECIFIC CONTRAST MEDIA: WHERE DO WE STAND?
HEPATOCYTE SPECIFIC CONTRAST MEDIA: WHERE DO WE STAND? Andrew T. Trout, MD @AndrewTroutMD Disclosures No relevant disclosures Outline Review of hepatocyte specific contrast media Review of hepatocellular
More informationAnatomical and Functional MRI of the Pancreas
Anatomical and Functional MRI of the Pancreas MA Bali, MD, T Metens, PhD Erasme Hospital Free University of Brussels Belgium mbali@ulb.ac.be Introduction The use of MRI to investigate the pancreas has
More informationSulfur hexafluoride-filled microbubbles SonoVue 3-7microns diameter Blood pool agent
Sulfur hexafluoride-filled microbubbles SonoVue 3-7microns diameter Blood pool agent Extremely good tolerance in clinical practice - No nephrotoxicity, - No thyroid interaction - No need of Blood test
More informationRole of imaging in RCC. Ultrasonography. Solid lesion. Cystic RCC. Solid RCC 31/08/60. From Diagnosis to Treatment: the Radiologist Perspective
Role of imaging in RCC From Diagnosis to Treatment: the Radiologist Perspective Diagnosis Staging Follow up Imaging modalities Limitations and pitfalls Duangkamon Prapruttam, MD Department of Therapeutic
More informationAcknowledgements. Update of Focal Liver Lesions Goals. Focal Liver Lesions. Imaging Choices For Liver Lesions. Focal Liver Lesions
Acknowledgements Update of Focal Liver Lesions 2012 Giles Boland Massachusetts General Hospital Harvard Medical School No disclosures Dushyant Sahani Mukesh Harisinghani Goals Focal liver lesions Imaging
More informationTHYROID NODULES: THE ROLE OF ULTRASOUND
THYROID NODULES: THE ROLE OF ULTRASOUND NOVEMBER 2017 DR. DEAN DURANT DEFINITION Thyroid nodule: Focal area within the thyroid gland with echogenicity different from surrounding parenchyma. THYROID NODULES
More informationDue to its relatively low cost, safety and
Original Article / Liver Clinical value of contrast-enhanced ultrasonography in the characterization of focal liver lesions: a prospective multicenter trial Wen-Ping Wang, Ying Wu, Yan Luo, Rui Li, Xiao-Dong
More informationDiagnostic efficacy of Gd-EOB-DTPA (Primovist)-enhanced MR imaging and CT for hepatocellular carcinoma
Diagnostic efficacy of Gd-EOB-DTPA (Primovist)-enhanced MR imaging and CT for hepatocellular carcinoma Poster No.: C-0124 Congress: ECR 2010 Type: Scientific Exhibit Topic: Abdominal Viscera (Solid Organs)
More informationHEPATO-BILIARY IMAGING
HEPATO-BILIARY IMAGING BY MAMDOUH MAHFOUZ MD PROF.OF RADIOLOGY CAIRO UNIVERSITY mamdouh.m5@gmail.com www.ssregypt.com CT ABDOMEN Indications Patient preparation Patient position Scanogram Fasting 4-6 hours
More informationImpact of reader's experience in contrast-enhanced ultrasonography (CEUS) management of patients with indeterminate liver lesions
Impact of reader's experience in contrast-enhanced ultrasonography (CEUS) management of patients with indeterminate liver lesions Poster No.: C-1699 Congress: ECR 2011 Type: Scientific Paper Authors: E.
More informationThe Focal Hepatic Lesion: Radiologic Assessment
The Focal Hepatic Lesion: Radiologic Assessment Kevin Kuo, Harvard Medical School Year III Our Patient: PS 67 y/o female w/ long history of alcohol use Drinking since age 18, up to one bottle of wine/day
More informationDiffusion-weighted images (DWI) without ADC values in assessment of small focal nodules in cirrhotic liver
Original Article Diffusion-weighted images (DWI) without ADC values in assessment of small focal nodules in cirrhotic liver Mai-Lin Chen, Xiao-Yan Zhang, Li-Ping Qi, Qing-Lei Shi, Bin Chen, Ying-Shi Sun
More informationHCC e CEUS. Prof. A. Giorgio. Direttore IX UOC di Malattie Infettive ad Indirizzo Ecointerventistico
HCC e CEUS Prof. A. Giorgio Direttore IX UOC di Malattie Infettive ad Indirizzo Ecointerventistico The natural history of compensated cirrhosis due to hepatitis C virus: a 17 year cohort study of 214 patients
More informationEvangelos Chartampilas Bioclinic Hospital Thessaloniki, Greece
Evangelos Chartampilas Bioclinic Hospital Thessaloniki, Greece Hepatospecificcontrast agents Gadobenate dimeglumine (Multihance) Gadoxeticacid (Primovist) 3-5% liver uptake 50% liver uptake Hepatobiliary
More informationElastosonography. Prof. Massimo Midiri Direttore Istituto di Radiologia Policlinico Universitario Paolo Giaccone Diagnostica per Immagini, - Palermo
Elastosonography Prof. Massimo Midiri Direttore Istituto di Radiologia Policlinico Universitario Paolo Giaccone Diagnostica per Immagini, - Palermo everybody has certainly had, at least once in a lifetime,
More informationMagnetic resonance imaging findings of hepatocellular carcinoma: typical and atypical findings
Asian Biomedicine Vol. 4 No. 1 February 2010; 113-124 Clinical report Magnetic resonance imaging findings of hepatocellular carcinoma: typical and atypical findings Laddawan Vajragupta, Khanitha Kittisatra,
More informationHyperplasia / Hypertrophy, Cirrhosis, Diagnostic procedure, MR, CT-Angiography, CT, Liver, Abdomen /ecr2012/C-2202
Hepatic nodules showing ring-like enhancement on hepatobiliary phase of Gd-EOB-DTPA enhanced MRI can be divided into two subtypes based on blood supply: FNH and NRH-like nodules Poster No.: C-2202 Congress:
More informationLiver imaging takes a step forward with Ingenia
Publication for the Philips MRI Community ISSUE 49 2013 / 2 Liver imaging takes a step forward with Ingenia Lyon South Hospital strives to move from several studies first CT, then MR or PET to using just
More informationRenal Cell Carcinoma and Renal Angiomyolipoma
Article Renal Cell Carcinoma and Renal Angiomyolipoma Differential Diagnosis With Real-time Contrast-Enhanced Ultrasonography Zuo-Feng Xu, MD, PhD, Hui-Xiong Xu, MD, PhD, Xiao-Yan Xie, MD, PhD, Guang-Jian
More informationSonography of soft-tissue vascular lesions
Sonography of soft-tissue vascular lesions Oscar M. Navarro Associate Professor, University of Toronto Dept. of Diagnostic Imaging, The Hospital for Sick Children Toronto, Canada Declaration of Disclosure
More informationContrast Enhanced Voiding Urosonography (cevus): How we do it
Contrast Enhanced Voiding Urosonography (cevus): How we do it Susan J. Back, MD Department of Radiology, The Children s Hospital of Philadelphia No Disclosures cevus What it is What to do What not to do
More informationThe clinical sign of pleurisy is characterized by a
Contrast-Enhanced Sonography for Differential Diagnosis of Pleurisy and Focal Pleural Lesions of Unknown Cause* Christian Görg, MD; Tillmann Bert, MD; and Konrad Görg, MD Background: Ultrasound enables
More informationObjectives. HCC Incidence and Mortality. Disclosure Statement HCC. Imaging of Hepatocellular Carcinoma. Treatment of Hepatocellular Carcinoma
Imaging of Hepatocellular Carcinoma and the use of LI RADS Treatment of Hepatocellular Carcinoma Aaron D. Anderson, D.O. AOCR April 2015 Objectives Show how the use of LI RADS can simplify the diagnosis
More informationContrast enhanced ultrasound (CEUS) in gallbladder and bile duct pathology: technique, interpretation and clinical applications
Contrast enhanced ultrasound (CEUS) in gallbladder and bile duct pathology: technique, interpretation and clinical applications Poster No.: C-2099 Congress: ECR 2011 Type: Scientific Exhibit Authors: E.
More informationImaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound
The British Journal of Radiology, 83 (2010), 411 418 Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound 1 Z WANG, MD, 1 H-X XU, MD, PhD, 1 X-Y XIE, MD, PhD, 1 X-H XIE,
More informationACG Clinical Guideline: Diagnosis and Management of Focal Liver Lesions
ACG Clinical Guideline: Diagnosis and Management of Focal Liver Lesions Jorge A. Marrero, MD, 1 Joseph Ahn, MD, FACG, 2 K. Rajender Reddy, MD, FACG 3 1 University of Texas at Southwestern, Dallas, Texas,
More informationCONTRAST-ENHANCED ULTRASOUND: PRINCIPLES OF CLINICAL UTILISATION
Vet Times The website for the veterinary profession https://www.vettimes.co.uk CONTRAST-ENHANCED ULTRASOUND: PRINCIPLES OF CLINICAL UTILISATION Author : Andrew Holloway, Mike Herrtage Categories : Vets
More informationCan Color Doppler Sonography Aid in the Prediction of Malignancy of Thyroid Nodules?
Article Can Color Doppler Sonography Aid in the Prediction of Malignancy of Thyroid Nodules? Mary C. Frates, MD, Carol B. Benson, MD, Peter M. Doubilet, MD, PhD, Edmund S. Cibas, MD, Ellen Marqusee, MD
More informationMRI OF FOCAL LESIONS IN
Introduction MRI OF FOCAL LESIONS IN THE NON-CIRRHOTIC LIVER Ivan Pedrosa M.D. Ph.D. Associate Professor of Radiology and Advanced Imaging Research Center University of Texas Southwestern. Dallas, TX Incidental
More informationIs hepatotropic contrast enhanced MR a more effective method in differential diagnosis of hemangioma than multi-phase CT and unenhanced MR?
RESEARCH ARTICLE Open Access Is hepatotropic contrast enhanced MR a more effective method in differential diagnosis of hemangioma than multi-phase CT and unenhanced MR? Edyta Szurowska 1*, Tomasz Nowicki
More informationByung Ihn Choi, M.D. Department of Radiology Seoul National University Hospital
Byung Ihn Choi, M.D. Department of Radiology Seoul National University Hospital CEUS & US Elastography : Contents CEUS Introduction Contrast agents & imaging Clinical application US Video WS Summary US
More informationDiffusion-weighted MRI of metastatic liver lesions: is there a difference between hypervascular and hypovascular metastases?
Original Article Diffusion-weighted MRI of metastatic liver lesions: is there a difference between hypervascular and hypovascular metastases? Acta Radiologica 2014, Vol. 55(5) 515 523! The Foundation Acta
More informationAlice Fung, MD Oregon Health and Science University
Alice Fung, MD Oregon Health and Science University Disclosure Comments The speaker Alice Fung, MD Has relevant financial relationships to disclose. Received honorarium from (Guerbet). This individual
More informationDiagnostics guidance Published: 29 August 2012 nice.org.uk/guidance/dg5
SonoVue (sulphur hexafluoride microbubbles) contrast agent for contrast-enhanced ultrasound imaging of the liver Diagnostics guidance Published: 29 August 2012 nice.org.uk/guidance/dg5 NICE 2018. All rights
More informationHepatic Imaging: What Every Practitioner Should Know
Hepatic Imaging: What Every Practitioner Should Know Shuchi K. Rodgers, MD Section Chief, Abdominal Imaging Director of Ultrasound Department of Radiology Einstein Medical Center rodgerss@einstein.edu
More informationLarge Nonmalignant Hepatic Mass and Role of Pediatric Interventional Radiology
Originally Posted: December 18, 2014 Large Nonmalignant Hepatic Mass and Role of Pediatric Interventional Radiology Resident(s): Kushal R Parikh, MD Attending(s): Jonathan R Dillman, MD and Ranjith Vellody,
More informationContrast-Enhanced Ultrasound in Assessing Therapeutic Response in Ablative Treatments of Hepatocellular Carcinoma
Contrast-Enhanced Ultrasound in Assessing Therapeutic Response in Ablative Treatments of Hepatocellular Carcinoma Zeno Sparchez 1, Pompilia Radu 1, Ofelia Anton 1, Mihai Socaciu 2, Radu Badea 1 1) 3 rd
More informationSmall Liver Nodule Detection With a High-Frequency Transducer in Patients With Chronic Liver Disease
SE SERIES Small Liver Nodule Detection With a High-Frequency Transducer in Patients With hronic Liver Disease Report of 3 cases nnemarie uadu, MD, Monique. Meyer, MD We report 3 cases in which small liver
More informationDetection of Liver Metastases
Article Detection of Liver Metastases Comparison of Contrast-Enhanced Wide-Band Harmonic Imaging With Conventional Ultrasonography Thomas Bernatik, MD, Deike Strobel, MD, Eckhart G. Hahn, MD, Dirk Becker,
More informationFocal fatty sparing and focal fatty infiltration can be observed in the
Diagn Interv Radiol 2011; 17:323 327 Turkish Society of Radiology 2011 ABDOMINAL IMAGING ORIGINAL ARTICLE Focal sparing of iron and fat in liver tissue in patients with hemosiderosis: diagnosis with combination
More informationIT 의료융합 1 차임상세미나 복부질환초음파 이재영
IT 의료융합 1 차임상세미나 2013-4-3 복부질환초음파 이재영 나는오늘누구를위하여 종을울리나? 전통적의료 의사 공학설계자 의사 최첨단진단장비들 USG, CT, MRI 환자 환자 현대의료 사용자중심의사고 US in the Abdomen Detection DDx Look Behavior Response by external stimuli Guiding Tool
More informationMRI of Small Hepatocellular Carcinoma: Typical Features Are Less Frequent Below a Size Cutoff of 1.5 cm
Gastrointestinal Imaging Original Research Choi et al. MRI of Small HCC Gastrointestinal Imaging Original Research Moon Hyung Choi 1 Joon-Il Choi 1 Young Joon Lee 1 Michael Yong Park 1 Sung Eun Rha 1 Chandana
More informationMR Imaging of Hepatic Metastases Caused by Neuroendocrine Tumors: Comparing Four Techniques
Clarisse Dromain 1 Thierry de Baere 1 Eric Baudin 2 Joel Galline 1 Michel Ducreux 3 Valérie Boige 3 Pierre Duvillard 4 Agnès Laplanche 5 Hubert Caillet 1 Philippe Lasser 6 Martin Schlumberger 2 Robert
More informationUltrasound of soft-tissue vascular anomalies
Ultrasound of soft-tissue vascular anomalies Oscar M. Navarro Associate Professor, University of Toronto Dept. of Diagnostic Imaging, The Hospital for Sick Children Toronto, Canada Declaration of Disclosure
More informationPeliosis Hepatis: Spectrum of Imaging Findings
Imaging of Peliosis Hepatis Hepatobiliary Imaging Pictorial Essay D E M N E U T R Y L I M I G O F I N G Riccardo Iannaccone 1,2 Michael P. Federle 3 Giuseppe rancatelli 4,5 Osamu Matsui 6 Elliot K. Fishman
More informationContrast Enhanced US
Contrast Enhanced US c/o Dr Stephanie Wilson Deborah Rubens MD Professor of Imaging Sciences, Biomedical Engineering and Oncology University of Rochester Medical Center None Disclosures Thank You Dr Stephanie
More informationUltrasound Physics & Doppler
Ultrasound Physics & Doppler Endocrine University 2018 Mark Lupo, MD, FACE, ECNU Objectives Review the essential components of ultrasound physics in neck sonography Demonstrate the importance of ultrasound
More informationNewcastle HPB MDM updated radiology imaging protocol recommendations. Author Dr John Scott. Consultant Radiologist Freeman Hospital
Newcastle HPB MDM updated radiology imaging protocol recommendations Author Dr John Scott. Consultant Radiologist Freeman Hospital This document is intended as a guide to aid radiologists and clinicians
More informationDiagnostic TRUS Elastography of the Prostate
Diagnostic TRUS Elastography of the Prostate George Zacharopoulos Department of Diagnostic Ultrasound Hygeia Hospital Athens, Greece Prostate HI-RTE Why we need Elastography Better Detection of possible
More informationThyroid Nodules: US Risk Stratification. Alex Tessnow, MD, FACE, ECNU University of Texas Southwestern Associate Professor of Medicine Dallas, Texas
Thyroid Nodules: US Risk Stratification Alex Tessnow, MD, FACE, ECNU University of Texas Southwestern Associate Professor of Medicine Dallas, Texas Which of the following is true? A. All echogenic foci
More informationSonographic Features of Thyroid Nodules & Guidelines for Management
Sonographic Features of Thyroid Nodules & Guidelines for Management Mark A. Lupo, MD, FACE, ECNU Thyroid & Endocrine Center of Florida Assistant Clinical Professor of Medicine Florida State University,
More informationInteresting Cases from Liver Tumor Board. Jeffrey C. Weinreb, M.D.,FACR Yale University School of Medicine
Interesting Cases from Liver Tumor Board Jeffrey C. Weinreb, M.D.,FACR Yale University School of Medicine jeffrey.weinreb@yale.edu Common Liver Diseases Hemangioma Cyst FNH Focal Fat/Sparing THID Non-Cirrhotic
More informationSimplifying liver assessment in internal medicine
Ultrasound Customer story Simplifying liver assessment in internal medicine Philips Affiniti ultrasound for elastography and contrast-enhanced ultrasound (CEUS) Where Sonography Institute, Uster, Switzerland
More informationHepatic hemangiomas are known to be the most. Contrast-Enhanced Ultrasound of Histologically Proven Liver Hemangiomas. Patients and Methods
Contrast-Enhanced Ultrasound of Histologically Proven Liver Hemangiomas Christoph F. Dietrich, 1 Joachim C. Mertens, 1 Barbara Braden, 2 Gudrun Schuessler, 1 Michaela Ott, 1 and Andre Ignee 1 Differentiation
More informationInternational Journal of Current Medical Sciences- Vol. 6, Issue,, pp , June, 2016 A B S T R A C T
ISSN: 2320-8147 International Journal of Current Medical Sciences- Vol. 6, Issue,, pp. 122-126, June, 2016 COMPUTED TOMOGRAPHY IN HEPATIC METASTASES Ananthakumar P and Adaikkappan M., Available online
More information