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Imaging-based diagnosis of benign lesions and pseudolesions in the cirrhotic liver
- Source :
- Magnetic Resonance Imaging. 75:9-20
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Liver cirrhosis is a leading cause of death worldwide, with 1-year mortality rates of up to 57% in decompensated patients. Hepatocellular carcinoma (HCC) is the most common primary tumor in cirrhotic livers and the second leading cause of cancer-related mortality worldwide. Annually, up to 8% of patients with cirrhosis develop HCC. The diagnosis of HCC rarely requires histological confirmation: in fact, according to the most recent guidelines, the imaging features of HCC are almost always sufficient for a certain diagnosis. Thus, the role of the radiologist is pivotal because the accurate detection and characterization of focal liver lesions in patients with cirrhosis are essential in improving clinical outcomes. Despite recent technical innovations in liver imaging, several issues remain for radiologists regarding the differentiation of HCC from other hepatic lesions, particularly benign lesions and pseudolesions. It is important to avoid misdiagnosis of benign liver lesions as HCC (false-positive cases) because this diagnostic misinterpretation may lead to ineligibility of a patient for potentially curative treatments or inappropriate assignment of high priority scores to patients on waiting lists for liver transplantation. This review presents a pocket guide that could be useful for the radiologist in the diagnosis of benign lesions and pseudolesions in cirrhotic livers, highlighting the imaging features that help in making the correct diagnosis of macroregenerative nodules; siderotic nodules; arterioportal shunts; hemangiomas, including fast-filling hemangiomas, hemangiomas with pseudowashout, and sclerosed hemangiomas; confluent fibrosis; pseudomasses in chronic portal vein thrombosis; and focal fatty changes.
- Subjects :
- Diagnostic Imaging
Liver Cirrhosis
medicine.medical_specialty
Carcinoma, Hepatocellular
Cirrhosis
Fibrosi
medicine.medical_treatment
Biomedical Engineering
Biophysics
Liver transplantation
030218 nuclear medicine & medical imaging
Diagnosis, Differential
03 medical and health sciences
Magnetic resonance imaging
0302 clinical medicine
Fibrosis
Neoplasms
medicine
Humans
Radiology, Nuclear Medicine and imaging
Cause of death
Cirrhosi
medicine.diagnostic_test
business.industry
Liver Neoplasms
medicine.disease
Primary tumor
Portal vein thrombosis
Hepatocellular carcinoma
Radiology
business
030217 neurology & neurosurgery
Diagnosi
Subjects
Details
- ISSN :
- 0730725X
- Volume :
- 75
- Database :
- OpenAIRE
- Journal :
- Magnetic Resonance Imaging
- Accession number :
- edsair.doi.dedup.....98f4821d60bc83bff0973d93984a6154