Nodule in Liver: Investigations, Differential Diagnosis and Follow-up

Journal of Clinical and Experimental Hepatology
Padaki N Rao

Abstract

Conventional ultrasonogram of the abdomen being noninvasive, inexpensive and ubiquitously available is the first imaging modality that raises suspicion of HCC in a patient with chronic liver disease with or without cirrhosis. The lesions in liver particularly nodule are being recognized with increased frequency with the wide spread use of ultrasonogram as the initial investigation and computerized tomography and magnetic resonance imaging subsequently. Any nodule in a cirrhotic liver should be considered as hepatocellular carcinoma until otherwise proved. This approach certainly is helpful in diagnosing HCC at its earliest possible stage to offer meaningful curative measures be it transplant, resection or ablative therapy. After a nodule is detected on ultrasonogram the next imaging modality can be a contrast enhanced study (dynamic CT scan or an MRI) to see if are present or not. Two vital clues for diagnosis of HCC by contrast enhanced imaging are presence of arterial hypervascularity and washout which are considered as "classical imaging features". This sequence of events of arterial uptake followed by washout is highly specific for diagnosis of HCC by imaging. If the features are typical showing classical imaging features (...Continue Reading

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Citations

Oct 8, 2015·Clinical Hemorheology and Microcirculation·Liliana ChioreanChristoph F Dietrich
May 28, 2019·Expert Review of Gastroenterology & Hepatology·Haruki KomatsuTomoo Fujisawa
Dec 14, 2018·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Abuduaiheti MaimaitimingPei Zhang

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