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36 Cards in this Set
- Front
- Back
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most primary hepatic tumors get blood supply from where
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hepatic arteries
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do HCC have restricted diffusion
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yes, most do
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how should pts at high risk for HCC be screened
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US q6 months, if they are high risk
if a nodule <1cm is seen, repeat US in 3 monhts >1cm nodule, do dynamic contrast-enhanced CT or MR if that study does not look like HCC, then perform other modality or bx |
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pathology of intrahepatic cholangioCA
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adenoCA of intrahepatic bile ducts
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risk factors for intrahepatic cholangio
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liver flukes (clonorchis)
hepatolithiasis, pyogenic cholangitis PSC cirrhosis hepatits fibrocystic dz of liver (caroli, hepatic fibrosis, etc) |
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findings that should make you think of cholangioCA
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atrophy of the liver
progressive central enhancement ductal dilatation |
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hepatic tumors with central scar
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FNH
fibrolamellar giant cavernous hemangioma |
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describe enhancement of FNH
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arterial phase intense uniform nodular enhancement
iso-sligh hyperenhancement in PV and equilibrium phase delayed enhancement of central scar (b/c of fibrous tissue) scar high on T2 |
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who gets fibrolamellar CA
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young pts, m=f
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appearance of fibrolamellar CA
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arterial phase: hetero hyperattenuation with progressive homogeneity
variable delayed enhancement of central scar ****scar low on T2****, scar may have calcs LAD associated |
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how does scar differ in fibrolamellar and FNH
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FNH: high on T2
fibrolamellar: low on T2, scar may have calcs |
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size criteria for giant cavernous hemangioma
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>4cm
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appearance of central scar in giant cavernous hemangioma
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high T2
scar doesn't enhance |
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enhancement pattern of giant cavernous hemangioma
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peripheral nodular enhancement
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fat containing tumors of liver
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hepatocellular adenoma
angiomyolipoma |
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who gets hepatic adenoma
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women, reproductive age
often on oral contraceptives |
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risk for hemorrhage in hepatic adenomas
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if >5cm
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MR appearance of hepatic adenoma
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there are different types, but many have diffuse signal drop-out on out-of-phase imaging
T2 iso to slightly hyperintense moderate arterial enhancement often will p/w hemorrhage |
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on MRI, how to differentiate FNH from hepatic adenoma
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if you use hepatobiliary agent, FNH will enhance, adenoma will not
less enhancement of adenoma on arterial phase |
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appearance of hepatic pyogenic abscess
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multilocular ("bunch of grapes"
thick septations poorly defined, enhancing rim |
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appearance of biliary cystadenoma
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uni/multi-loculated
encapsulated thick septations looks like a multilocular cystic nephroma of the liver |
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complication of biliary cystadenoma
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can have malignant potential
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which liver lesion is the "no" lesion and what does that mean
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FNH
not pre-malig, not assoc with OCP, no hemorrhage, no capsule |
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what disease is hepatic adenoma assoc w
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glycogen storage disease
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why is the liver the densest organ in the abdomen
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b/c of glycogen
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eovist
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biliary secreting contrast agent
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which organs are affected in primary hemochromatosis
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heart
liver panc |
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sequellae of primary hemochromatosis
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CMP
HCC DM |
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organs affected in secondary hemochromatosis
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liver
spleen BM LN |
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what is TE in-phase and out of phase
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in phase: 4.2 msec
out of phase: 2.1 msec |
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veno-occlusive disease
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will cause reversal of flow in portal vein
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ddx differential of central and peripheral perfusion
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budd chiari
PSC |
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most common cause of splenic cysts
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trauma
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benign solid neoplasm of spleen
MC? |
hemangioma**
hamartoma |
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malignant neoplasms of the spleen
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primary hemangiosarcoma
lymphoma mets (melanoma, breast, lung) |
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etiology of splenic cysts
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true epithelial cysts (post-traumatic)
panc pseudocyst cystic lymphangioma |
