39-Dr Ahmed Esawy imaging oral board of liver part III MRI liver

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Transcript of 39-Dr Ahmed Esawy imaging oral board of liver part III MRI liver

The Art of Radiology

Simple hepatic cysts

Simple hepatic cysts

F.N.H.

Focal Nodular Hyperplasia

Focal Nodular Hyperplasia

FNH (A) & H.C.C (B)

H.C.C (A). F.N.H (B)

H.C.C. (A&C) &F.N...H (B&D)

CT with contrast, note the fat (red arrow) & vascular components of the hepatic lesion with involvement of the RT kidney in patient with Tuberous Sclerosis.

Angiomyolipoma

NODULES in cirrhotic liver

1 )Regenerative or mildly dysplastic nodules (RNs)

2 )Dysplastic nodules DNs

3 )Nodule-within-nodule

Fibrous tissue :

Confluent fibrosis

malignant

HCC

Types of H.C.C

Infiltrating HCC with P. V. thrombus

Fig (9- I) Infiltrating HCC with P. V. thrombus

Infiltrating H.C.C. with I.V.C. & cardiac thrombosis

Signs of arterioportal shunting

FIBROLAMELLAR HCCFHCC

FIBROLAMELLAR HCCFHCC

metastasis

The metastatic lesion is hyperintense on both T1 & T2

Mucenous containing colonic metastasis

Calcified metastasis from mucenous containing colonic CA

Target sign

Halo sign

Peripheral washout sign 25%

Wash out sign

Hyper intense on T1 Melanotic melanoma metastasis

Mucen producing T .

Capsule based liver metastasis

Types of CHOLANGIOCARCINOMA

 Intrahepatic or peripheral type

Klatskin tumor

Klatsken tumor

Ampullary Carcinoma

Hemangioendothelioma

(2 )Epithelioid hemangioendothelioma

Portal hypertenstion

Portal vein thrombosis

Axial CT with contrast, the portal vein is dilated which does not enhance centrally with enhanced wall Acute

bland thrombosis

Fatty/steatosis

Marked steatosis

Diffuse fat with scar in 55 y/f. with T.T.T.from breast C.A .

Hemochromatosis :

Hemosiderosis

Hemosiderosis

Stages :

Primary hemochromatosis (the liver is only affected with preserved spleen) with CA

Early primary type hemochromatosis (the liver is only affected with preserved

spleen)

Pyogenic liver abscess (Double-target appearance)

Abscess, with gas fluid level

Amebic abscess

Hydatid disease