Contents
Foreword I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VII Foreword II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VIII Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IX How to Use This Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
Part I High-Fluid Content Liver Lesions |
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1 |
Abscesses – Pyogenic Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
2 |
2 |
Biliary Hamartomas (von Meyenberg Complexes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
4 |
3 |
Cyst I – Typical Small . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
6 |
4 |
Cyst II – Typical Large with MR-CT Correlation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
8 |
5 |
Cyst III – Multiple Small Lesions with MR-CT-US Comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . |
10 |
6 |
Cyst IV – Adult Polycystic Liver Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
12 |
7 |
Cystadenoma / Cystadenocarcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
14 |
8 |
Hemangioma I – Typical Small . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
16 |
9 |
Hemangioma II – Typical Medium-Sized with Description of Pathology . . . . . . . . . . . . . . . . . . . |
18 |
10 |
Hemangioma III – Typical Giant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
20 |
11 |
Hemangioma IV – Giant Type with a Large Central Scar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
22 |
12 |
Hemangioma V – Atypical, Flash-Filling with Perilesional Enhancement . . . . . . . . . . . . . . . . . . |
24 |
13 |
Hemangioma VI – Multiple with Perilesional Enhancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
26 |
14 |
Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
28 |
15 |
Hemorrhage – Within a Solid Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
30 |
16 |
Mucinous Metastasis – Mimicking an Hemangioma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
32 |
Part II Solid Liver Lesions
IIA |
Metastases: Colorectal |
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17 |
Colorectal Metastases I – Typical Lesion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
36 |
18 |
Colorectal Metastases II – Typical Multiple Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
38 |
19 |
Colorectal Metastases III – Metastasis Versus Cyst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
40 |
20 |
Colorectal Metastases IV – Metastasis Versus Hemangiomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
42 |
21 |
Liver Metastases V – Large, Mucinous, Mimicking a Primary Liver Lesion . . . . . . . . . . . . . . . . . |
44 |
22 |
Colorectal Metastases VI – with Portal Vein and Bile Duct Encasement . . . . . . . . . . . . . . . . . . . . |
46 |
23 |
Colorectal Metastases VII – Recurrent Disease Versus RFA Defect . . . . . . . . . . . . . . . . . . . . . . . . |
48 |
IIB |
Metastases: Non-Colorectal |
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24 |
Breast Carcinoma Liver Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
52 |
25 |
Kahler’s Disease (Multiple Myeloma) Liver Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
54 |
26 |
Melanoma Liver Metastases I – Focal Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
56 |
27 |
Melanoma Liver Metastases II – Diffuse Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
58 |
28 |
Neuroendocrine Tumor I – Typical Liver Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
60 |
29 |
Neuroendocrine Tumor II – Pancreas Tumor Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
62 |
30 |
Neuroendocrine Tumor III – Gastrinoma Liver Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
64 |
31 |
Neuroendocrine Tumor IV – Carcinoid Tumor Liver Metastases . . . . . . . . . . . . . . . . . . . . . . . . . |
66 |
32 |
Neuroendocrine Tumor V – Peritoneal Spread . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
68 |
33 |
Ovarian Tumor Liver Metastases – Mimicking Giant Hemangioma . . . . . . . . . . . . . . . . . . . . . . . |
70 |
34 |
Renal Cell Carcinoma Liver Metastasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
72 |
IIC |
Primary Solid Liver Lesions in Cirrhotic Liver |
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35 |
Cirrhosis I – Liver Morphology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
76 |
36 |
Cirrhosis II – Regenerative Nodules and Confluent Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
78 |
37 |
Cirrhosis III – Dysplastic Nodules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
80 |
38 |
Cirrhosis IV – Dysplastic Nodules – HCC Transition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
82 |
39 |
Cirrhosis V – Cyst in a Cirrhotic Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
84 |
XII |
Contents |
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40 |
Cirrhosis VI – Multiple Cysts in a Cirrhotic Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
86 |
41 |
Cirrhosis VII – Hemangioma in a Cirrhotic Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
88 |
42 |
HCC in Cirrhosis I – Typical Small with Pathologic Correlation . . . . . . . . . . . . . . . . . . . . . . . . . |
90 |
43 |
HCC in Cirrhosis II – Small With and Without a Tumor Capsule . . . . . . . . . . . . . . . . . . . . . . . . |
92 |
44 |
HCC in Cirrhosis III – Nodule-in-Nodule Appearance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
94 |
45 |
HCC in Cirrhosis IV – Mosaic Pattern with Pathologic Correlation . . . . . . . . . . . . . . . . . . . . . . |
96 |
46 |
HCC in Cirrhosis V – Typical Large with Mosaic and Capsule . . . . . . . . . . . . . . . . . . . . . . . . . . |
98 |
47 |
HCC in Cirrhosis VI – Mosaic Pattern with Fatty Infiltration . . . . . . . . . . . . . . . . . . . . . . . . . . . |
100 |
48 |
HCC in Cirrhosis VII – Large Growing Lesion with Portal Invasion . . . . . . . . . . . . . . . . . . . . . . |
102 |
49 |
HCC in Cirrhosis VIII – Segmental Diffuse with Portal Vein Thrombosis . . . . . . . . . . . . . . . . . |
104 |
50 |
HCC in Cirrhosis IX – Multiple Lesions Growing on Follow-up . . . . . . . . . . . . . . . . . . . . . . . . . |
106 |
51 |
HCC in Cirrhosis X – Capsular Retraction and Suspected Diaphragm Invasion . . . . . . . . . . . . |
108 |
52 |
HCC in Cirrhosis XI – Diffuse Within the Entire Liver with Portal Vein Thrombosis . . . . . . . . |
110 |
53 |
HCC in Cirrhosis XII – With Intrahepatic Bile Duct Dilatation . . . . . . . . . . . . . . . . . . . . . . . . . . |
112 |
IID Primary Solid Liver Lesions in Non-Cirrhotic Liver |
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54 |
Focal Nodular Hyperplasia I – Typical with Large Central Scar and Septa . . . . . . . . . . . . . . . . . |
116 |
55 |
Focal Nodular Hyperplasia II – Typical with Pathologic Correlation . . . . . . . . . . . . . . . . . . . . . |
118 |
56 |
Focal Nodular Hyperplasia III – Typical with Follow-up Examination . . . . . . . . . . . . . . . . . . . . |
120 |
57 |
Focal Nodular Hyperplasia IV – Multiple FNH Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
122 |
58 |
Focal Nodular Hyperplasia V – Fatty FNH with Concurrent Fatty Adenoma . . . . . . . . . . . . . . |
124 |
59 |
Focal Nodular Hyperplasia VI – Atypical with T2 Dark Central Scar . . . . . . . . . . . . . . . . . . . . . |
126 |
60 |
Hepatic Angiomyolipoma – MR-CT Comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
128 |
61 |
Hepatic Lipoma – MR-CT-US Comparison . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
130 |
62 |
Hepatocellular Adenoma I – Typical with Pathologic Correlation . . . . . . . . . . . . . . . . . . . . . . . . |
132 |
63 |
Hepatocellular Adenoma II – Large Exophytic with Pathologic Correlation . . . . . . . . . . . . . . . |
134 |
64 |
Hepatocellular Adenoma III – Typical Fat-Containing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
136 |
65 |
Hepatocellular Adenoma IV – With Large Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
138 |
66 |
Hepatocellular Adenoma V – Multiple in Fatty Liver (Non-OC-Dependent) . . . . . . . . . . . . . . . |
140 |
67 |
Hepatocellular Adenoma VI – Multiple in Fatty Liver (OC-Dependent) . . . . . . . . . . . . . . . . . . . |
142 |
68 |
HCC in Non-Cirrhotic Liver I – Small with MR-Pathologic Correlation . . . . . . . . . . . . . . . . . . . |
144 |
69 |
HCC in Non-Cirrhotic Liver II – Large with MR-Pathologic Correlation . . . . . . . . . . . . . . . . . . |
146 |
70 |
HCC in Non-Cirrhotic Liver III – Large Lesion with Inconclusive CT . . . . . . . . . . . . . . . . . . . . |
148 |
71 |
HCC in Non-Cirrhotic Liver IV – Cholangiocellular or Combined Type . . . . . . . . . . . . . . . . . . |
150 |
72 |
HCC in Non-Cirrhotic Liver V – Central Scar and Capsule Rupture . . . . . . . . . . . . . . . . . . . . . . |
152 |
73 |
HCC in Non-Cirrhotic Liver VI – Capsule with Pathologic Correlation . . . . . . . . . . . . . . . . . . . |
154 |
74 |
HCC in Non-Cirrhotic Liver VII – Very Large with Pathologic Correlation . . . . . . . . . . . . . . . . |
156 |
75 |
HCC in Non-Cirrhotic Liver VIII – Vascular Invasion and Satellite Nodules . . . . . . . . . . . . . . . |
158 |
76 |
HCC in Non-Cirrhotic Liver IX – Adenoma-Like HCC with Pathologic Correlation . . . . . . . . |
160 |
77 |
Intrahepatic Cholangiocarcinoma – With Pathologic Correlation . . . . . . . . . . . . . . . . . . . . . . . . |
162 |
78 |
Telangiectatic Hepatocellular Lesion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
164 |
Part III Diffuse (Depositional) Liver Diseases
79 Focal Fatty Infiltration Mimicking Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 80 Focal Fatty Sparing Mimicking Liver Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 81 Hemosiderosis – Iron Deposition, Acquired Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 82 Hemochromatosis – Severe Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 83 Hemochromatosis with Solitary HCC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 84 Hemochromatosis with Multiple HCC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 85 Thalassemia with Iron Deposition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Part IV Vascular Liver Lesions
86 Arterioportal Shunt I – Early Enhancing Lesion in a Cirrhotic Liver . . . . . . . . . . . . . . . . . . . . . 184 87 Arterioportal Shunt II – Early Enhancing Lesion in a Non-Cirrhotic Liver . . . . . . . . . . . . . . . . 186 88 Budd-Chiari Syndrome I – Abnormal Enhancement and Intrahepatic Collaterals . . . . . . . . . . 188 89 Budd-Chiari Syndrome II – Gradual Deformation of the Liver . . . . . . . . . . . . . . . . . . . . . . . . . . 190 90 Budd-Chiari Syndrome III – Nodules Mimicking Malignancy . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 91 Hereditary Hemorrhagic Telangiectasia (HHT) or Rendu-Osler-Weber Disease . . . . . . . . . . . . 194
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Contents |
XIII |
Part V Biliary Tree Abnormalities |
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|
92 |
Caroli’s Disease I – Intrahepatic with Segmental Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
198 |
93 |
Caroli’s Disease II – Involvement of the Liver and Kidneys . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
200 |
94 |
Cholelithiasis (Gallbladder Stones) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
202 |
95 |
Choledocholithiasis (Bile Duct Stones) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
204 |
96 |
Gallbladder Carcinoma I – Versus Gallbladder Wall Edema . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
206 |
97 |
Gallbladder Carcinoma II – Hepatoid Type of Adenocarcinoma . . . . . . . . . . . . . . . . . . . . . . . . |
208 |
98 |
Hilar Cholangiocarcinoma I – Typical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
210 |
99 |
Hilar Cholangiocarcinoma II – Intrahepatic Mass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
212 |
100 |
Hilar Cholangiocarcinoma III – Partially Extrahepatic Tumor . . . . . . . . . . . . . . . . . . . . . . . . . |
214 |
101 |
Hilar Cholangiocarcinoma IV – Metal Stent with Interval Growth . . . . . . . . . . . . . . . . . . . . . . |
216 |
102 |
Hilar Cholangiocarcinoma V – Biliary Dilatation Mimicking Klatskin Tumor at CT . . . . . . . |
218 |
103 |
Primary Sclerosing Cholangitis I – Cholangitis and Segmental Atrophy . . . . . . . . . . . . . . . . . |
220 |
104 |
Primary Sclerosing Cholangitis II – With Intrahepatic Cholestasis . . . . . . . . . . . . . . . . . . . . . . |
222 |
105 |
Primary Sclerosing Cholangitis III – With Intrahepatic Stones . . . . . . . . . . . . . . . . . . . . . . . . . |
224 |
106 |
Primary Sclerosing Cholangitis IV – With Biliary Cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
226 |
107 |
Primary Sclerosing Cholangitis V – With Intrahepatic Cholangiocarcinoma . . . . . . . . . . . . . |
228 |
108 |
Primary Sclerosing Cholangitis VI – With Hilar Cholangiocarcinoma . . . . . . . . . . . . . . . . . . . |
230 |
Part VI Differential Diagnosis |
|
|
109 |
T2 Bright Liver Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
234 |
110 |
T1 Bright Liver Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
236 |
111 |
T2 Bright Central Scar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
238 |
112 |
Lesions in Fatty Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
240 |
Part VII Appendices |
|
|
113 |
Appendix I: MR Imaging Technique and Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
244 |
114 |
Appendix II: Liver Segmental and Vascular Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
246 |
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
249 |
|
Part I
High-Fluid Content Liver Lesions |
I |