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Liver Lesions (liver + lesion)

Distribution by Scientific Domains
Medical Sciences97%
Distribution within Medical Sciences
Hepatology20%
12 Other Subdomains60%

Kinds of Liver Lesions

  • focal liver lesion
    		•

    Selected Abstracts

    The protective action of scutellarin against immunological liver injury induced by concanavalin A and its effect on pro-inflammatory cytokines in mice

    JOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2007
    Zheng Huai Tan
    Scutellarin is a natural compound from a Chinese herb. The purpose of this paper was to study the protective effect of scutellarin on concanavalin A (Con A)-induced immunological liver injury and its effect on liver nuclear factor ,B (NF-,B), tumor necrosis factor , (TNF-,), interferon , (IFN-,), and inducible nitric oxide synthase (iNOS) expression in mice. Mouse liver injury was produced by injection of Con A 25 mg kg,1 via the tail vein. Scutellarin 50 or 100 mg kg,1 was peritoneally administered to mice 9 or 1 h before injection of Con A. The levels of serum alanine aminotransferase (ALT) and asparatate aminotransferase (AST), NO2,/NO3, and TNF - , were determined with biochemical kits, and ELISA using Quantikine Mouse TNF-, kit according the manufacturer's instructions. Liver lesions were examined by light microscope. The expression of TNF-,, IFN-,, iNOS and Fas mRNA in the livers was detected by RT-PCR; and the expression of c-Fos, c-Jun, iNOS and I,B proteins was measured by Western Blotting. As a result, pretreatment with scutellarin 100 mg kg,1 significantly decreased the serum ALT, AST, NO2,/NO3,and TNF-, levels, and also reduced liver lesions induced by Con A. Scutellarin 100 mg kg,1 down-regulated expression of TNF-, and iNOS mRNA, and c-Fos, c-Jun and iNOS protein, while scutellarin enhanced the degradation of I,B, in the livers of mice injected with Con A. The results suggest that scutellarin has a protective action against Con A-induced liver injury in mice, and its active mechanism may be related to the inhibition of the NF-,B-TNF-,-iNOS transduction pathway. [source]

    Mouse Strain Susceptibility to Diethylnitrosamine Induced Hepatocarcinogenesis Is Cell Autonomous Whereas Sex-susceptibility Is Due to the Micro-environment: Analysis with C3H , BALB/c Sexually Chimeric Mice

    CANCER SCIENCE, Issue 7 2000
    Tetsuya Tsukamoto
    In man, liver cancer is on the increase, especially in males. Sex differences also exist in rodent models. To elucidate the mechanisms, chimeric mice were produced by amalgamation of early embryos from high and low hepatocarcinogen-susceptible strains, C3H and BALB/c. Tumor formation was initiated with 10 mg/kg of diethylnitrosamine at the ages of 7 and 14 days and mice were sacrificed at 30 and 45 weeks. The chimeras were classified into XY,XY, XY,XX, XX,XY, and XX,XX in terms of sex chromosomes by means of polymerase chain reaction-simple sequence length polymorphism analysis (SSLP) using Y chromosome-specific Sry primers in combination with the D3Mit21 marker. Liver lesions were analyzed histopathologically, by immunostaining using a C3H strain-specific antibody and by DNA in situ hybridization with the Y chromosomespecific digoxigenin-labeled Y353/B probe. Sex and strain genotyping by SSLP analysis matched histological observations, confirming the reliability of our system. The strain differences in liver tumor numbers of each strain type in XY,XY and XX,XX subtypes of C3H,BALB/c chimeras were retained well (P< 0.0001 and P< 0.001, respectively), indicating a minimum influence of the C3H or BALB/c surrounding milieu on development of individual lesions. On the other hand, significant promotion of XX cell tumors was evident in phenotypically male sexually chimeric XY,XX and XX,XY chimeras for both C3H (P< 0.02) and BALB/c (P< 0.01) lesions compared to the XX,XX case. The results suggest the presence of hormonal or micro-environmental factors specific for males, which are not caused cell-autonomously. Basic strain differences, however, are determined by intrinsic genetic factors rather than the strain-dependent micro-environment [source]

    Spindle-cell lesions of the liver: Diagnosis by fine-needle aspiration biopsy

    DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2001
    Cynthia D. Guy M.D.
    Abstract Rarely, spindle-cell lesions in liver fine-needle aspiration biopsies (FNABs) are encountered. A retrospective review of our experience with lesions that are mesenchymal in origin or appearance was undertaken to elucidate the frequency and spectrum of these lesions. Image-guided liver FNABs performed over a 3-year period (n = 585) at our institution (1996,1998) were retrospectively evaluated. Cytologic smears, cell block preparations, and clinical follow-up of lesions with spindle-cell morphology were reviewed. Twenty-nine of 585 cases were of spindle-cell morphology (5%). Hemangiomas (n = 12, 41%) and metastatic sarcomas (n = 6, 21%) comprised the largest categories, followed by granulomatous inflammation (n = 3, 10%). Other cases included primary angiosarcoma and fibrolamellar hepatocellular carcinoma. The most frequent spindle-cell liver lesion encountered is hemangioma, followed by metastatic leiomyosarcoma and granulomatous hepatitis. Awareness of diagnostic possibilities, special attention to specimen adequacy, and use of ancillary procedures can maximize diagnostic yield. Diagn. Cytopathol. 2001;25:94,100. © 2001 Wiley-Liss, Inc. [source]

    Telangiectatic adenoma: An entity associated with increased body mass index and inflammation,

    HEPATOLOGY, Issue 1 2007
    Valérie Paradis
    What were previously called telangiectatic focal nodular hyperplasias are in fact true adenomas with telangiectatic features (TAs) without overt characterized genetic abnormalities. The aim of our study was to review a surgical series of TAs in order to describe clinical, biological, and radiological findings of these lesions and to evaluate their outcomes. From January 1996 to November 2005, 284 patients with benign hepatocellular nodules underwent surgical resection at Beaujon Hospital. Among them, 32 TAs from 27 patients were diagnosed. Ninety-two percent of the patients were women. Mean age was 38 years (range 17,63). Mean body mass index was 28 (range 18,49), with 16 patients being overweight. Symptoms revealed lesions in 10 patients. In 13 patients, TA was associated with another benign liver lesion. Mean size of the TAs was 5 cm (range 1,17 cm). Histological analysis showed cellular atypias in 6 cases (19%), steatosis in 17 cases (53%), vascular changes in 19 cases (59%), and significant inflammatory infiltrate in 29 cases (91%). In 1 case, the TA had foci of well-differentiated hepatocellular carcinoma. In 18 of the 26 cases (69%), adjacent liver showed significant steatosis. Serum biomarkers of inflammation were increased in 90% of patients (19 of 22). After surgical resection, inflammatory marker levels returned to normal values in all patients tested. Conclusion: This study has shown that TAs occur in a characteristic background of overweight patients and are often associated with a biological inflammatory syndrome. Moreover, a TA may progress to malignancy. (HEPATOLOGY 2007;46:140,146.) [source]

    The hepatoprotective effects of Limonium sinense against carbon tetrachloride and , -D-galactosamine intoxication in rats

    PHYTOTHERAPY RESEARCH, Issue 7 2003
    Shang-Shing Chaung
    Abstract In the present study, the hepatoprotective action of Limonium sinense (Plumbaginaceae) was evident after carbon tetrachloride (CCl4) and , -D-galactosamine (D-GalN), respectively, challenge in rats. The plant materials were divided into two parts: (1) the roots extracted with water (WRE) and (2) the leaves extracted with methanol and fractionated with chloroform (CLE). Both WRE and CLE were extremely ,avonoid-enriched extracts. In an CCl4 -induced acute liver damage study, pretreatment with WRE at 300 mg/kg i.p. and CLE at 100 mg/kg i.p. signi,cantly reduced the amino-transaminases levels of SGOT (p < 0.01) and SGPT (p < 0.01) previously increased by CCl4 intoxication. In D-GalN-induced acute liver damage study, administration of WRE (300 and 500 mg/kg) or CLE (100 mg/kg) p.o. also signi,cantly reduced the SGOT (p < 0.01) and SGPT (p < 0.01) levels previously increased by D-GalN intoxication. Furthermore, the serum triglyceride level was increased after pretreatment with WRE or CLE previously reduced by D-GalN intoxication. All of the liver function pro,les were con,rmed to have improvement of liver lesion in histopathological obsvervation. In an acute toxicity test on ICR mice, the LD50 of WRE was 777.6 mg/kg i.p. An in vitro study showed that CLE possessed a more potent cytotoxicity to human hepatocellular carcinoma cells (Hep3B) (EC50 = 43.1 µg/mL) than the other organic fractions, which were fractionated from methanol extracts of the leaves of L. sinense. The present results conclude that L. sinense possesses a hepatoprotective ef,cacy, and is relatively safe in rats. Copyright © 2003 John Wiley & Sons, Ltd. [source]

    Incidental liver lesion in a young boy

    ANZ JOURNAL OF SURGERY, Issue 1-2 2009
    Jennifer Shoobridge BMedSci, MB BS (Hon)
    No abstract is available for this article. [source]

    Role of FDG-PET in surgical management of patients with colorectal liver metastases

    ANZ JOURNAL OF SURGERY, Issue 8 2004
    Benjamin D. Teague
    Background: [ 18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) is reported to change the management in 20,56% of patients with recurrent or metastatic colorectal cancer. It is not clear if FDG-PET has a role in all such patients or only a subgroup. The aim of the present study was to assess the influence of FDG-PET on the surgical management of patients with known or suspected colorectal liver metastases. Methods: Patients undergoing FDG-PET for investigation of known or suspected colorectal liver metastases were identified from a South Australian database. Case notes were reviewed retrospectively to determine the influence of FDG-PET findings on patient management. Findings from FDG-PET scanning were compared with findings from conventional diagnostic investigations and operative findings. Results: Overall, in four of 16 patients (25%) management was influenced by FDG-PET findings. FDG-PET altered management in four of eight (50%) patients with non-diagnostic liver lesions on computed tomography (CT) or with elevated carcinoembryonic antigen levels but no liver lesion on CT. In all eight patients with CT diagnosed resectable liver metastases, the addition of FDG-PET did not influence the management. Conclusions: The findings support the use of FDG-PET in the assessment of selected patients with suspected colorectal liver metastases and equivocal findings on conventional diagnostic investigation. [source]

    Epithelioid angiosarcoma: A neoplasm with potential diagnostic challenges

    DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2010
    Christine F. Lin B.S. (Student)
    Abstract Epithelioid angiosarcomas are extremely rare tumors associated with poor prognosis and early metastases. Its epithelioid cytomorphology and limited vasoformation make it difficult to distinguish from more common malignancies, such as, carcinoma. This can be a potential diagnostic pitfall for the cytopathologist. In this report, the patient is a 24-year-old man presenting with testicular pain, a pelvic mass, and innumerable liver nodules. Immediate interpretation of the needle core biopsies of the pelvic mass and liver lesions initially favored a poorly differentiated adenocarcinoma. Unusual positive immunohistochemical stains for CD30 and CK7 ultimately led the investigation toward a tumor of mesenchymal origin. Further, immunohistochemical evaluation demonstrated positive CD31 and Factor VIII staining and established the final diagnosis of epithelioid angiosarcoma. The tumor cells were negative for CD34, CK20, alpha-fetoprotein, placental-like alkaline phosphatase, hepatocyte paraffin 1, polyclonal carcinoembryonic antigen, CD10, CA-125, prostate-specific antigen, and prostatic acid phosphatase. This case is reported to illustrate the importance of considering the diagnosis of epithelioid angiosarcoma when encountering an "epithelioid" neoplasm particularly with unusual immunoreactivity for CK7 and CD30. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source]

    The amazing universe of hepatic microstructure,

    HEPATOLOGY, Issue 2 2009
    Valeer J. Desmet
    An informal review is presented by the author of his 50 years of involvement in practice and research in hepatopathology. Some background for the author's attitude and meandering pathway into his professional career serves as introduction to a short discussion of the main topics of his interest and expertise. Histogenesis of liver cancer was the theme of early work for a Ph.D. thesis, the results of which were lost into oblivion due to local rules and circumstances, but were rescued three decades later. His conclusions about the cells of origin of liver cancer remain concordant with the newer concepts in the field after nearly half a century. Studies in the field of chronic hepatitis became a long saga, involving the first classification of this syndrome by "the Gnomes" in 1968, histochemical investigations of viral antigens, lymphocyte subsets and adhesion molecules, and a quarter century later, the creation of a new classification presently in use. Cholestasis was a broadening field in diagnostic entities and involved the study of liver lesions, comprising pathways of bile regurgitation (including reversed secretory polarity of hepatocytes) and so-called ductular reaction. The latter topic has a high importance for the various roles it plays in modulating liver tissue of chronic cholestasis into biliary cirrhosis, and as the territory of hepatic progenitor cells, crucial for liver regeneration in adverse conditions and in development of liver cancer. Study of the embryology of intrahepatic bile ducts helped to clarify the strange appearance of the ducts in "ductal plate configuration" in several conditions, including some forms of biliary atresia with poor prognosis and all varieties of fibrocystic bile duct diseases with "ductal plate malformation" as the basic morphologic lesion. (HEPATOLOGY 2009;50:333,344.) [source]

    Liver damage underlying unexplained transaminase elevation in human immunodeficiency virus-1 mono-infected patients on antiretroviral therapy,

    HEPATOLOGY, Issue 2 2009
    Patrick Ingiliz
    Liver damage associated with chronic unexplained high serum transaminases in human immunodeficiency virus (HIV)-infected patients under combined antiretroviral therapy is unknown. Liver histology was prospectively investigated in patients presenting serum transaminase elevation for more than 6 months, after exclusion of alcohol abuse, hepatitis C virus (HCV) or hepatitis B virus (HBV) infection, autoimmune, and genetic liver diseases. In a subgroup of patients, liver mitochondrial activities were measured by spectrophotometry and mitochondrial DNA (mtDNA) by real-time polymerase chain reaction (PCR). Thirty patients were included with median values of alanine aminotransferase (ALT) levels: 80 U/L, age: 46 years, body mass index: 23 kg/m2, HIV RNA: 200 copies/mL, CD4 count: 365/mm3, duration of HIV infection: 13 years, and duration of treatment exposure: 118, 41, and 53 months for nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors, respectively. Histological anomalies were found in 22 of 30 patients. Steatosis was present in 18 patients, severe in nine patients, and associated with inflammation in 16 patients with a diagnosis of non-alcoholic steatohepatitis (NASH). Fibrosis was found in 18 patients, severe in six patients and associated with steatosis in 13 patients. Significant liver respiratory complex I defect, contrasting with high complex IV activity and normal mitochondrial DNA content, was observed in the group of patients compared with controls. The presence of NASH was correlated with high fasting glycemia and insulin levels, not with liver mitochondrial function or mitochondrial DNA content. Conclusions: HIV-infected patients on combined antiretroviral therapy with chronic transaminase elevation of unknown origin have a high rate of liver lesions, mostly consistent with NASH related to insulin resistance. (HEPATOLOGY 2008.) [source]

    Cell cycle deregulation in liver lesions of rats with and without genetic predisposition to hepatocarcinogenesis

    HEPATOLOGY, Issue 6 2002
    Rosa M. Pascale
    Preneoplastic and neoplastic hepatocytes undergo c-Myc up-regulation and overgrowth in rats genetically susceptible to hepatocarcinogenesis, but not in resistant rats. Because c-Myc regulates the pRb-E2F pathway, we evaluated cell cycle gene expression in neoplastic nodules and hepatocellular carcinomas (HCCs), induced by initiation/selection (IS) protocols 40 and 70 weeks after diethylnitrosamine treatment, in susceptible Fisher 344 (F344) rats, and resistant Wistar and Brown Norway (BN) rats. No interstrain differences in gene expression occurred in normal liver. Overexpression of c- myc, Cyclins D1, E, and A, and E2F1 genes, at messenger RNA (mRNA) and protein levels, rise in Cyclin D1-CDK4, Cyclin E-CDK2, and E2F1-DP1 complexes, and pRb hyperphosphorylation occurred in nodules and HCCs of F344 rats. Expression of Cdk4, Cdk2, p16INK4A, and p27KIP1 did not change. In nodules and/or HCCs of Wistar and BN rats, low or no increases in c- myc, Cyclins D1, E, and A, and E2F1 expression, and Cyclin-CDKs complex formation were associated with p16INK4A overexpression and pRb hypophosphorylation. In conclusion, these results suggest deregulation of G1 and S phases in liver lesions of susceptible rats and block of G1-S transition in lesions of resistant strains, which explains their low progression capacity. [source]

    Hepatocarcinogenesis in Female Mice With Mosaic Expression of Connexin32

    HEPATOLOGY, Issue 3 2000
    Oliver Moennikes
    Mice deficient for connexin32 (Cx32), the major gap junction forming protein in liver, are highly susceptible to hepatocarcinogenesis. Because the Cx32 gene is located on the X-chromosome, heterozygous females show mosaicism with respect to Cx32 expression; this enables their use in studying the effect of Cx32-deficiency in a mixed Cx32-plus/Cx32-minus environment in vivo. Female C3H/He mice (Cx32+/+) were crossed with Cx32-deficient C57BL/129Sv males (Cx32Y/- ) to yield F1 females heterozygous with respect to Cx32 (Cx32+/,). Patches of hepatocytes were observed in normal liver that either expressed Cx32 or failed to express the protein. The mean fraction of Cx32-negative tissue in liver was about 60% and did not change significantly with age of mice. Neoplastic liver lesions, induced in weanling mice, were identified in serial liver sections by their deficiency in glucose-6-phosphatase staining. Parallel sections were used for immunohistochemical demonstration of Cx32 protein. Smaller lesions were either homogenously Cx32-negative or showed unchanged to slightly elevated levels of Cx32 protein. There were no major differences in number and size distribution between lesions of these 2 phenotypes. In addition, larger lesions were mostly Cx32-negative but often contained embedded patches of Cx32-positive cells. Staining for the proliferation-associated nuclear antigen Ki-67 did not reveal significant differences between Cx32-negative and Cx32-positive hepatocytes in Cx32-mosaic tumors. This suggests that expression of Cx32 within a subpopulation of tumor cells does not negatively regulate their growth nor does it seem to affect the proliferation of their directly neighboring Cx32-negative counterparts. [source]

    Improved diagnosis of well-differentiated hepatocellular carcinoma with gadolinium ethoxybenzyl diethylene triamine pentaacetic acid-enhanced magnetic resonance imaging and Sonazoid contrast-enhanced ultrasonography

    HEPATOLOGY RESEARCH, Issue 9 2010
    Natsuko Kawada
    Aim:, Two new imaging modalities have been developed recently that are directed at the focal liver lesions: gadolinium ethoxybenzyl diethylene triamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and Sonazoid contrast-enhanced ultrasonography (CEUS). We investigated the usefulness of these modalities for the diagnosis of small (<2 cm), well-differentiated hepatocellular carcinoma (HCC). Methods:, A total of 15 nodules from 13 patients, which were histologically diagnosed as well-differentiated HCC, were subjected to this study. Lesions that showed hypervascularity in the arterial phase and washout in the portal or late non-hemodynamic phase were regarded as HCC in the dynamic studies of all imaging modalities. Results:, By multidetector computed tomography (MDCT), six of 15 (40%) nodules were diagnosed as HCC. Gd-EOB-DTPA-enhanced MRI diagnosed HCC in nine of the 15 (60%) nodules. Of the nine nodules that were not diagnosed by MDCT, four could be diagnosed by Gd-EOB-DTPA-enhanced MRI. In Sonazoid CEUS, 10 of 15 nodules (67%) were diagnosed as HCC. Four of nine nodules that could not be diagnosed as HCC by MDCT, were diagnosed by Sonazoid CEUS. A total of 11 of the 15 (73%) nodules were diagnosed as HCC by Gd-EOB-DTPA-enhanced MRI and Sonazoid CEUS in addition to MDCT. Conclusion:, Gd-EOB-DTPA-enhanced MRI and Sonazoid CEUS had greater diagnostic value for small, well-differentiated HCC than did conventional MDCT. [source]

    A diagnostic paradigm for resectable liver lesions: to biopsy or not to biopsy?

    HPB, Issue 7 2009
    Adrian B. Cresswell
    Abstract Background:, Despite a growing body of evidence reporting the deleterious mechanical and oncological complications of biopsy of hepatic malignancy, a small but significant number of patients undergo the procedure prior to specialist surgical referral. Biopsy has been shown to result in poorer longterm survival following resection and advances in modern imaging modalities provide equivalent, or better, diagnostic accuracy. Methods:, The literature relating to needle-tract seeding of primary and secondary liver cancers was reviewed. MEDLINE, EMBASE and the Cochrane Library were searched for case reports and series relating to the oncological complications of biopsy of liver malignancies. Current non-invasive diagnostic modalities are reviewed and their diagnostic accuracy presented. Results:, Biopsy of malignant liver lesions has been shown to result in poorer longterm survival following resection and does not confer any diagnostic advantage over a combination of non-invasive imaging techniques and serum tumour markers. Conclusions:, Given that chemotherapeutic advances now often permit downstaging and subsequent resection of ,unresectable' disease, the time has come to abandon biopsy of solid lesions outside the setting of a specialist multi-disciplinary team meeting (MDT). [source]

    Mutagenic Safety and Fatty Liver Improvement of Nanonized Black Soybeans in Senescence-Accelerated Prone-8 Mice

    JOURNAL OF FOOD SCIENCE, Issue 5 2010
    J.-W. Liao
    Abstract:, Nanotechnology, as a new enabling technology, has the potential to revolutionize food systems. However, much attention has been focused on nanoparticle foods due to their potential physiological properties. This study was aimed to evaluate the mutagenic safety and fatty liver improvement of black soybean in senescence-accelerated mice (SAMP8). The mutagenic activity of black soybeans was investigated using the Ames test (Salmonella Typhimurium,TA98, 100, 102, and 1535). Furthermore, senescence-accelerated prone-8 mice (SAMP8) have been reported to display spontaneous fatty liver. Male SAMP8 mice were divided into control and supplemented with 10% micronized or nanonized black soybeans diet and fed for 12 wk. The results revealed that the Ames test of micronized and nanonized black soybeans exhibited no mutagenicity. Administration of black soybeans to mice showed no effects on food intake and body and organ weights. The nanonized black soybean group had a lower degree of spontaneous fatty liver, alanine aminotransferase, and thiobarbituric acid-reactive substance concentrations, and had enhanced superoxide dismutase, catalase, and glutathione peroxidase activities of livers when compared with the SAMP8 control and micronized black soybean groups. The mice fed with black soybeans had significantly lower triglyceride concentrations than the SAMP8 control group. The results of this study suggest that nanonized black soybeans have no side effects and, moreover, may minimize liver lesions in SAMP8 mice. [source]

    Comparison of ferucarbotran-enhanced fluid-attenuated inversion-recovery echo-planar, T2-weighted turbo spin-echo, T2*-weighted gradient-echo, and diffusion-weighted echo-planar imaging for detection of malignant liver lesions

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2010
    Yoshihiko Fukukura MD
    Abstract Purpose: To compare the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced fluid-attenuated inversion-recovery echo-planar imaging (FLAIR EPI) for malignant liver tumors with that of T2-weighted turbo spin-echo (TSE), T2*-weighted gradient-echo (GRE), and diffusion-weighted echo-planar imaging (DW EPI). Materials and Methods: SPIO-enhanced magnetic resonance imaging (MRI) that included FLAIR EPI, T2-weighted TSE, T2*-weighted GRE, and DW EPI sequences was performed using a 3 T system in 54 consecutive patients who underwent surgical exploration with intraoperative ultrasonography. A total of 88 malignant liver tumors were evaluated. Images were reviewed independently by two blinded observers who used a 5-point confidence scale to identify lesions. Results were correlated with results of histopathologic findings and surgical exploration with intraoperative ultrasonography. The accuracy of each MRI sequence was measured with jackknife alternative free-response receiver operating characteristic analysis. The sensitivity of each observer with each MRI sequence was compared with McNemar's test. Results: Accuracy values were significantly higher with FLAIR EPI sequence (0.93) than with T2*-weighted GRE (0.80) or DW EPI sequences (0.80) (P < 0.05). Sensitivity was significantly higher with the FLAIR EPI sequence than with any of the other sequences. Conclusion: SPIO-enhanced FLAIR EPI sequence was more accurate in the diagnosis of malignant liver tumors than T2*-weighted GRE and DW EPI sequences. SPIO-enhanced FLAIR EPI sequence is helpful for the detection of malignant liver tumors. J. Magn. Reson. Imaging 2010;31:607,616. ©2010 Wiley-Liss, Inc. [source]

    Resovist enhanced MR imaging of the liver: Does quantitative assessment help in focal lesion classification and characterization?

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2009
    Lucia Santoro MD
    Abstract Purpose: To improve characterization of focal liver lesions by a prospective quantitative analysis of percentage signal intensity change, in dynamic and late phases after slow (0.5 mL/s) Resovist administration. Materials and Methods: Seventy-three patients were submitted on clinical indication to MR examination with Resovist. Signal intensity of 92 detected focal lesions (5,80 mm) were measured with regions of interest and normalized to paravertebral muscle in arterial, portal, equilibrium and T1/T2 late phases, by two observers in conference. Five values of percentage variations per patient were obtained and statistically evaluated. Results: The enhancement obtained on dynamic study is more suitable in hemangiomas and focal nodular hyperplasias than in adenomas and hepatocellular carcinomas. To discriminate benign versus malignant lesions on late-phase-T2-weighted images, a cutoff = ,26%, allowed sensitivity and specificity values of 97.4% and 97.7%, respectively. Area under the receiver operating characteristic (ROC) curve was 0.99. To differentiate hemangioma versus all other focal liver lesions, on late-phase-T1-weighted images, a cutoff = +40% permitted sensitivity and specificity values of 90.5% and 98.0%, respectively. Area under the ROC curve was 0.98. Conclusion: Late phase quantitative evaluation after slow Resovist administration, allows to differentiate malignant from benign hepatic masses and hemangiomas from all the others focal liver lesions, on T2-/T1-weighted acquisitions, respectively. J. Magn. Reson. Imaging 2009;30:1012,1020. © 2009 Wiley-Liss, Inc. [source]

    Diffusion-weighted imaging of the liver: Comparison of navigator triggered and breathhold acquisitions

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2009
    Bachir Taouli MD
    Abstract Purpose To compare a free breathing navigator triggered single shot echoplanar imaging (SS EPI) diffusion-weighted imaging (DWI) sequence with prospective acquisition correction (PACE) with a breathhold (BH) DWI sequence for liver imaging. Materials and Methods Thirty-four patients were evaluated with PACE-DWI and BH DWI of the liver using b-values of 0, 50, and 500 s/mm2. There were 29 focal liver lesions in 18 patients. Qualitative evaluation was performed on a 3-point scale (1,3) by two independent observers (maximum score 9). Quantitative evaluation included estimated SNR (signal to noise ratio), lesion-to-liver contrast ratio, liver and lesion apparent diffusion coefficients (ADCs), and coefficient of variation (CV) of ADC in liver parenchyma and focal liver lesions (estimate of noise contamination in ADC). Results PACE-DWI showed significantly better image quality, higher SNR and lesion-to-liver contrast ratio when compared with BH DWI. ADCs of liver and focal lesions with both sequences were significantly correlated (r = 0.838 for liver parenchyma, and 0.904 for lesions, P < 0.0001), but lower with the BH sequence (P < 0.02). There was higher noise contamination in ADC measurement obtained with BH DWI (with a significantly higher SD and CV of ADC). Conclusion The use of a navigator echo to trigger SS EPI DWI improves image quality and liver to lesion contrast, and enables a more precise ADC quantification compared with BH DWI acquisition. J. Magn. Reson. Imaging 2009;30:561,568. © 2009 Wiley-Liss, Inc. [source]

    Evaluation of optimized inversion-recovery fat-suppression techniques for T2-weighted abdominal MR imaging

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2008
    Thomas C. Lauenstein MD
    Abstract Purpose To test the theoretical benefits of a spectral attenuated inversion-recovery (SPAIR) fat-suppression (FS) technique in clinical abdominal MRI by comparison to conventional inversion-recovery (IR) FS combined with T2-weighted (T2W) partial Fourier single shot fast spin echo (SSFSE). Materials and Methods 1.5T MRI studies of the abdomen were performed in 28 patients with liver lesions (hemangiomas n = 14; metastases n = 14). T2W sequences were acquired using IR and SPAIR SSFSE. Measurements included retroperitoneal and mesenteric fat signal-to-noise (SNR) to evaluate FS; liver lesion contrast-to-noise (CNR) to evaluate bulk water signal recovery effects; and bowel wall delineation to evaluate susceptibility and physiological motion effects. Results SPAIR-SSFSE images produce significantly improved FS and liver lesion CNR. The mean SNR of the retroperitoneal and mesenteric fat for SPAIR SSFSE was 20.5 ± 10.2 (±1 SD) and 12.7 ± 6.2, compared to 43.2 ± 24.1 (P = 0.000006) and 29.3 ± 16.8 (P = 0.0000005) for IR-SSFSE. SPAIR-SSFSE images produced higher CNR for both hemangiomas CNR = 164 ± 88 vs. 126 ± 83 (P = 0.00005) and metastases CNR = 75 ± 27 vs. 53 ± 19 (P = 0.007). Bowel wall visualization was significantly improved using SPAIR-SSFSE (P = 0.002). Conclusion The theoretical benefits of SPAIR over conventional IR FS translate into significant multiple improvements that can be measured on clinical abdominal MRI scans. J. Magn. Reson. Imaging 2008;27:1448,1454. © 2008 Wiley-Liss, Inc. [source]

    Focal liver lesions: Breathhold gradient- and spin-echo T2-weighted imaging for detection and characterization ,

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2006
    Takeshi Yoshikawa MD
    Abstract Purpose To evaluate breathhold gradient- and spin-echo (GRASE) T2-weighted imaging for the detection and characterization of focal liver lesions. Materials and Methods Two GRASE sequences with different echo times (75 and 90 msec, GRASE75 and GRASE90) were compared with respiratory-triggered fast spin-echo (SE) and breathhold fast SE in 64 patients with 103 malignant and 51 benign lesions. Compared with respiratory-triggered and breathhold fast SE, GRASE reduced scan time by 77% to 82% and 21% to 27%, respectively. Two independent readers evaluated image quality and reviewed 504 liver segments on a segment-by-segment basis. Observer performance was evaluated with receiver operating characteristic (ROC) curve analysis. The signal-to-noise ratio (SNR) of liver and spleen, and lesion-to-liver contrast-to-noise ratio (CNR) were also measured. Results The overall quality of the GRASE images was higher than that of the respiratory-triggered and breathhold fast SE images, although signal inhomogeneities were more frequently observed with GRASE. No significant difference in the values of the area under the ROC curve (Az) for malignant lesion detection was found. The mean SNR and CNR were highest for respiratory-triggered fast SE. Conclusion T2-weighted breathhold GRASE has the potential to provide faster liver imaging. J. Magn. Reson. Imaging 2006. © 2006 Wiley-Liss, Inc. [source]

    Diffusion-weighted images of the liver: Comparison of tumor detection before and after contrast enhancement with superparamagnetic iron oxide

    JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2005
    Shinji Naganawa MD
    Abstract Purpose To study the recognition of malignant lesions of the liver on diffusion-weighted images (DWI) can be improved by the administration of superparamagnetic iron oxide (SPIO). Materials and Methods Pre- and post-SPIO mediated DWI of the liver was compared in six patients with suspected malignant liver lesions at 1.5 Tesla using a parallel imaging technique. Results Post-SPIO DWI showed improved contrast-to-noise ratio between malignant lesions and liver. Furthermore, the spleen signal was decreased on post-SPIO DWI, thus avoiding the overlap of the spleen and left lobe of the liver on maximum intensity projections (MIP). Conclusion Recognition of malignant lesions of the liver was improved by SPIO on DWI. On MIP images of DWI, SPIO helped to decrease the overlap of spleen signal on the liver in some projection angles. J. Magn. Reson. Imaging 2005;21:836,840. © 2005 Wiley-Liss, Inc. [source]

    Effect of slice thickness on liver lesion detection and characterisation by multidetector CT

    JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2010
    JT Smith
    Summary The purpose of our study was to compare the effectiveness of 3.2 mm, 5 mm and 7.5 mm slice thicknesses in the detection and characterisation of liver lesions found on CT in patients with known or suspected malignant disease. 110 patients underwent portal phase imaging using four-slice MDCT. Two blinded observers independently read hard copy images at each slice thickness. The size and location of each lesion detected was recorded by each observer on a diagram of liver segmental anatomy. Each lesion was characterised as benign, malignant or indeterminate in nature. A diagnostic confidence score was allocated for each lesion on a scale of 1,4. The pathology or behaviour of lesions was assessed using surgery with intra-operative ultrasound (IOUS) and histology, or interval imaging with MRI, CT, or sonography. 294 lesions were detected, 64 (22%) of which were malignant. Both observers detected significantly more lesions on the 3.2 mm versus 7.5 mm slice thickness (p < 0.0001). Both observers detected more malignant lesions on 3.2 mm and 5 mm slice thicknesses versus 7.5 mm. As slice thickness decreased there was a significant increase in the sensitivity of malignant lesion detection for observer 1 (p < 0.001) and borderline significance for observer 2 (p = 0.07). As slice thickness decreased the proportion of lesions characterised as indeterminate by both observers fell. With thinner slices, both detection and characterisation of liver lesions were improved. A slice thickness no greater than 5 mm should be used to maximise both detection and correct characterisation of liver lesions. [source]

    Naturally occurring fatal herpes simplex virus 1 infection in a family of white-faced saki monkeys (Pithecia pithecia pithecia)

    JOURNAL OF MEDICAL PRIMATOLOGY, Issue 1 2003
    M.D. Schrenzel
    Abstract: A family of three white-faced saki monkeys (Pithecia pithecia pithecia) died 48,96 hours after the onset of anorexia, nasal discharge, pyrexia and oral ulceration. One animal also had clonic seizures. Lesions found post-mortem consisted of oral and esophageal ulcers, hepatic and intestinal necrosis, meningoencephalitis and sporadic neuronal necrosis. Intranuclear inclusion bodies and syncytial cells were present in oral lesions and affected areas of liver. Herpes simplex virus 1 (HSV-1) was identified as the etiology of disease by virus isolation, polymerase chain reaction, or in situ hybridization in all three animals. Immunohistochemistry for detection of apoptotic DNA and activated caspase-3 showed significant levels of apoptosis in oral and liver lesions and occasional apoptotic neurons in the brain. These findings demonstrate the vulnerability of white-faced saki monkeys to HSV-1 and provide initial insight into the pathogenesis of fatal HSV-1-induced disease, indicating that apoptosis plays a significant role in cell death. [source]

    The protective action of scutellarin against immunological liver injury induced by concanavalin A and its effect on pro-inflammatory cytokines in mice

    JOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 1 2007
    Zheng Huai Tan
    Scutellarin is a natural compound from a Chinese herb. The purpose of this paper was to study the protective effect of scutellarin on concanavalin A (Con A)-induced immunological liver injury and its effect on liver nuclear factor ,B (NF-,B), tumor necrosis factor , (TNF-,), interferon , (IFN-,), and inducible nitric oxide synthase (iNOS) expression in mice. Mouse liver injury was produced by injection of Con A 25 mg kg,1 via the tail vein. Scutellarin 50 or 100 mg kg,1 was peritoneally administered to mice 9 or 1 h before injection of Con A. The levels of serum alanine aminotransferase (ALT) and asparatate aminotransferase (AST), NO2,/NO3, and TNF - , were determined with biochemical kits, and ELISA using Quantikine Mouse TNF-, kit according the manufacturer's instructions. Liver lesions were examined by light microscope. The expression of TNF-,, IFN-,, iNOS and Fas mRNA in the livers was detected by RT-PCR; and the expression of c-Fos, c-Jun, iNOS and I,B proteins was measured by Western Blotting. As a result, pretreatment with scutellarin 100 mg kg,1 significantly decreased the serum ALT, AST, NO2,/NO3,and TNF-, levels, and also reduced liver lesions induced by Con A. Scutellarin 100 mg kg,1 down-regulated expression of TNF-, and iNOS mRNA, and c-Fos, c-Jun and iNOS protein, while scutellarin enhanced the degradation of I,B, in the livers of mice injected with Con A. The results suggest that scutellarin has a protective action against Con A-induced liver injury in mice, and its active mechanism may be related to the inhibition of the NF-,B-TNF-,-iNOS transduction pathway. [source]

    The evolving role of liver biopsy

    ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2004
    M. S. Campbell
    Summary Liver biopsy is traditionally the ,gold standard, for the evaluation of liver diseases. There are several situations in which its role is being challenged. In hepatitis C, liver biopsy helps assess prognosis and treatment candidacy. An important exception is genotype 2 or 3 because treatment is more likely to succeed and therapy is relatively short in duration. For hepatitis B, liver biopsy gives some prognostic information, but serologic tests and hepatic biochemical tests are the primary determinants of treatment candidacy. Non-alcoholic fatty liver disease can be accurately diagnosed without a liver biopsy and, furthermore, there are no specific therapies available. The role of liver biopsy to assess methotrexate-associated hepatotoxicity remains controversial. Finally, patients with focal liver lesions usually do not require biopsy and, in the case of hepatocellular carcinoma, biopsy carries a risk of needle-track seeding. In short, the need for liver biopsy depends on the specific situation and should be performed when there is sufficient uncertainty about diagnosis, severity of disease, prognosis, and treatment decisions. [source]

    Diagnostic imaging of hepatocellular carcinoma in patients with cirrhosis before liver transplantation

    LIVER TRANSPLANTATION, Issue S2 2006
    Bachir Taouli
    Key Concepts: 1The lack of whole-liver explant correlation has led to an overestimation of the sensitivity of imaging tests for the diagnosis of HCC in the radiological literature. 2Ultrasound is insensitive for the diagnosis of HCC in the cirrhotic liver and should not be used for the detection of focal liver lesions in this setting. 3Although magnetic resonance (MR) imaging is more sensitive than multidetector 3-phase computed tomography (CT) for the diagnosis of regenerative and dysplastic nodules it is probably no better than CT for detection of HCC and has a lower false-positive rate. 4Approximately 10,30% of nodules measuring <2 cm seen only on the hepatic arterial phase at CT or MR imaging represent small HCC and vigilant surveillance imaging is required as interval growth is the best indicator of malignancy. Liver Transpl 12:S1,S7, 2006. © 2006 AASLD. [source]

    Resection of liver metastases from colorectal cancer: does preoperative chemotherapy affect the accuracy of PET in preoperative planning?

    ANZ JOURNAL OF SURGERY, Issue 5 2009
    Sam Adie
    Abstract Background:, Preoperative scanning for hepatic colorectal metastases surgery remains a challenge, especially in the age of preoperative chemotherapy, which has marked biochemical and physical effects on the liver. Integrated fluoro-deoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) has applications for detecting extrahepatic disease. The aim of the present study was to investigate FDG-PET/CT as a preoperative planning tool for detecting liver lesions in patients with and without preoperative chemotherapy. Methods:, Patients who had resection of hepatic colorectal metastases between January 2004 and June 2006 were included. Patients were divided into those who received preoperative chemotherapy and those who did not. Malignant hepatic lesions found on each scan were compared with those found on histopathology, intraoperative examination and/or intraoperative ultrasound. Accurate scans (scan lesions corresponded to true lesions), false positives (scan lesions detected at least one non-lesion) and false negatives (scan lesions missed at least one true lesions) were recorded. Results were also compared on a per lesion basis. Results:, A total of 21 patients had preoperative FDG-PET/CT scans with preoperative chemotherapy and 53 without. Accurate tests were six (29%) for the chemotherapy group versus 28 (53%) for the non-chemotherapy group (P= 0.06). Notably, there were 11 (52%) underestimations in the chemotherapy group versus 18 (34%) in the non-chemotherapy group. A total of 1.7 lesions were missed per patient in the chemotherapy group versus 0.7 in those who did not receive chemotherapy. Conclusion:, Preoperative assessment with FDG-PET/CT is not useful for hepatic colorectal metastases, particularly when preoperative chemotherapy is used, with a trend towards underestimation of lesions. [source]

    Role of FDG-PET in surgical management of patients with colorectal liver metastases

    ANZ JOURNAL OF SURGERY, Issue 8 2004
    Benjamin D. Teague
    Background: [ 18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) is reported to change the management in 20,56% of patients with recurrent or metastatic colorectal cancer. It is not clear if FDG-PET has a role in all such patients or only a subgroup. The aim of the present study was to assess the influence of FDG-PET on the surgical management of patients with known or suspected colorectal liver metastases. Methods: Patients undergoing FDG-PET for investigation of known or suspected colorectal liver metastases were identified from a South Australian database. Case notes were reviewed retrospectively to determine the influence of FDG-PET findings on patient management. Findings from FDG-PET scanning were compared with findings from conventional diagnostic investigations and operative findings. Results: Overall, in four of 16 patients (25%) management was influenced by FDG-PET findings. FDG-PET altered management in four of eight (50%) patients with non-diagnostic liver lesions on computed tomography (CT) or with elevated carcinoembryonic antigen levels but no liver lesion on CT. In all eight patients with CT diagnosed resectable liver metastases, the addition of FDG-PET did not influence the management. Conclusions: The findings support the use of FDG-PET in the assessment of selected patients with suspected colorectal liver metastases and equivocal findings on conventional diagnostic investigation. [source]

    Multiple neonatal haemangiomatosis with liver haemangiomas and anaemia

    AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2008
    Vibhu Mendiratta
    SUMMARY A 5-month-old girl presented with six cutaneous haemangiomas that appeared over a 1-month period. Investigations revealed anaemia and multiple liver haemangiomas. After 3 months follow up, there has been some further enlargement of the cutaneous lesions but no increase in number, while the liver lesions have remained stable, without any other systemic complications. [source]

    Ten-year experience of totally laparoscopic liver resection in a single institution

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2009
    A. Sasaki
    Background: Recent developments in liver surgery include the introduction of laparoscopic liver resection. The aim of the present study was to review a single institution's 10-year experience of totally laparoscopic liver resection (TLLR). Methods: Between May 1997 and April 2008, 82 patients underwent TLLR for hepatocellular carcinoma (HCC) (37 patients), liver metastases (39) and benign liver lesions (six). Operations included 69 laparoscopic wedge resections, 11 laparoscopic left lateral sectionectomies and two thoracoscopic wedge resections. Nine patients underwent simultaneous laparoscopic resection of colorectal primary cancer and synchronous liver metastases. Results: Median operating time was 177 (range 70,430) min and blood loss 64 (range 1,917) ml. Median tumour size and surgical margin were 25 (range 15,85) and 6 (range 0,40) mm respectively. One procedure was converted to a laparoscopically assisted hepatectomy. Three patients developed complications. Median postoperative stay was 9 (range 3,37) days. The overall 5-year survival rate after surgery for HCC and colorectal metastases was 53 and 64 per cent respectively. Conclusion: TLLR can be performed safely for a variety of primary and secondary liver tumours, and seems to offer at least short-term benefits in selected patients. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]