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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

CT and MRI contribute important information to the clinical evaluation of diffuse liver disease. In some cases, these modalities can establish a diagnosis that was not ascertained histologically, which is often the case when sampling errors prevent a definitive tissue diagnosis. Characteristic alterations of liver attenuation on CT, signal changes on MRI, and morphological changes appreciated with both modalities can be used to diagnose fatty infiltration, some parenchymal deposition diseases, and cirrhosis. Furthermore, hepatocellular disease can be confirmed in the setting of indeterminate clinical and laboratory findings. Significant overlap in the imaging findings of this wide range of disorders continues to limit specificity; however, at a minimum, these techniques provide a rapid means to a noninvasive evaluation that often guides clinical decisions. Faster scanning techniques available with CT and MRI may provide additional information by assessing contrast dynamics. This review of CT and MRI in diffuse liver disease considers the diagnostic utility and clinical implications of these modalities. Pathological findings relevant to imaging considerations are discussed.
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PMID:CT and MRI of diffuse liver disease. 771 79

A variety of diffuse and focal disease processes affect the liver. MRI is likely the imaging modality of choice for investigation of patients suspected of having diffuse disease such as cirrhosis, hemochromatosis, or fatty infiltration. MRI is extremely effective at detecting and characterizing focal hepatic lesions. In particular, patients suspected of possessing hemangiomas, hepatocellular carcinoma, or hypervascular liver metastases are better evaluated by MRI than other imaging modalities. Immediate post gadolinium spoiled gradient echo and T2-weighted fat suppressed spin echo are very effective at lesion detection, whereas serial post gadolinium spoiled gradient echo is essential for lesion characterization. New fast T2-weighted sequences and tissue specific contrast agents may further increase the role of liver MRI by shortening exam time and increasing sensitivity and specificity, respectively.
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PMID:Magnetic resonance imaging of the liver. 777 72

Fibrolamellar carcinoma (FL-Ca) is a primary malignant liver tumor at unknown etiology, without cirrhosis and usually without an increase at tumor markers, which occurs mainly in young patients. As it can simulate malignant and benign tumors, particularly FNH, diagnosis is difficult. Ultrasound and angiography show mostly uncharacteristic features. The highest specificity has CT, if calcifications are present, because these calcifications in a tumor similar to FNH are pathognomonic for FL-Ca. In MRI the central scars of FL-Ca and FNH have a different signal intensity in T2-weighted images, so that MRI becomes more and more important in the differential diagnosis to FNH.
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PMID:[Fibrolamellar carcinoma]. 788 76

A 37-yr-old woman was admitted to our hospital for evaluation of diabetes mellitus, liver cirrhosis and primary amenorrhea. Serological and hematological examinations revealed that she suffered from hemochromatosis secondary to congenital dyserythropoietic anemia (CDA), characterized by ineffective hematopoiesis and erythropoietic dysplasia. Iron deposition was suggested by MRI on the pancreas, liver and pituitary gland. Endocrinological examinations demonstrated that she had isolated gonadotropin deficiency and ovarian failure, resulting in hypogonadotropic hypogonadism. In addition, despite normal responses of serum cortisol and plasma aldosterone to ACTH and furosemide-standing tests, respectively, serum dehydroepiandrosterone (DHEA) responded poorly to ACTH test, suggesting selective damage of zona reticularis in adrenocortical steroidogenesis in association with hemochromatosis.
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PMID:[Isolated gonadotropin deficiency and secretory discrepancy of cortisol and adrenal androgen by hemochromatosis secondary to congenital dyserythropoietic anemia]. 795 84

The utility of MRI using magnetization transfer (MT) enhanced pulse sequences to diagnose hepatic cirrhosis in a rat model was investigated. Hepatic T1 was measured with and without MT off-resonance RF pulses in 17 treated and six control rats. The livers were evaluated histologically, and the hydroxyproline content quantitatively measured. We did not find a statistically significant linear correlation between the MR relaxation times and the degree of tissue injury. However, the MR measurements performed with MT were superior to those without differentiating the treated and control groups. Specifically, the T1 times were 695 +/- 76 ms for the treated group, versus 748 +/- 61 ms in the controls; P = 0.095. The T1sat times were also lower in the treated group, with statistical significance: 367 +/- 51 ms versus 421 +/- 38 ms, P = 0.016. Finally, the change in the relaxation rates (the inverse of the relaxation times) with and without saturation were 1.31 +/- 0.22 s-1 (treated group) versus 1.05 +/- 0.12 s-1 (controls), which differed significantly, P = 0.001.
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PMID:Detection of liver fibrosis with magnetic cross-relaxation. 801 10

A fibrolamellar carcinoma (FL-Ca) is a primary malignant tumor of the liver of unknown etiology, without cirrhosis and usually without an increase in tumor markers; it occurs mainly in young patients. As it can simulate malignant and benign tumors, particularly focal nodular hypoplasia (FNH), the diagnosis is difficult. Ultrasound and angiography show mostly uncharacteristic features, so ultrasound only has to ascertain that the tumor is there. Angiography can reveal vascular infiltrations and assess the resectability of the tumor, but diagnosis of FL-Ca is not always possible with angiography. CT has the highest specificity if calcifications are present, because calcifications in a tumor similar to FNH are pathognomonic for FL-Ca. By means of hepatobiliary functional scintigraphy FNH can be excluded. MRI seems to be important in differentiating the tumor from FNH, because the central scars of FL-Ca and FNH--if present--have a different signal intensity in T2-weighted images. The histological diagnosis of FL-Ca is also difficult. In patients with resectable tumors or prior to liver transplantation, an operative biopsy should be obtained to verify the diagnosis. In non-resectable tumors sonographic guided biopsy is justified.
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PMID:[Diagnosis of fibrolamellar cancer]. 805 13

In 47 patients with liver cirrhosis, we performed dynamic MRI with a multisection FLASH technique that enabled us to obtain 13 T 1-weighted images of the entire liver within a single breath hold. Computed tomographic arterial portography (CTAP), US, CT, angiography (AOG) and MRI (spin echo [SE] and dynamic MRI) were performed in all 47 patients. Except for cyst, hemangioma and metastatic tumor, 104 focal nodules less than 3 cm in diameter were detected. These 104 focal lesions were divided into three groups according to the pattern of CTAP: 69 portal supply negative, 11 portal supply decreased, and 24 portal supply normal. In the portal supply negative group, 63 lesions (91%) were detected by dynamic MRI, which was superior to other modalities (US 77%, CT 41%, AOG 70%, MRI-SE 61%). The superiority of dynamic MRI resulted from its excellent ability to detect liver lesions less than 1 cm in diameter. We confirmed histologically that dynamic MRI had almost the same ability to detect hepatocellular carcinoma (HCC) as CTAP. Dynamic MRI should be clinically useful as a noninvasive examination for the detection of HCC.
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PMID:[Evaluation of multislice dynamic MR imaging of the whole liver]. 819 Jun 5

We studied 18 formalin-fixed brains using MRI, and correlated our data with subsequent gross and microscopic examinations. 9 of our patients died from brain diseases (stroke due to infarction 4, stroke due to hemorrhage 1, encephalitis 2, head injury 1, brain tumor 1). 9 of our patients died from non-CNS diseases (stomach cancer 1, colon cancer 1, liver cirrhosis 1, myocardial infarction 2, trauma 4). In MRI of postmortem brain, T1WI and T 2WI was able to clearly show the myelination process of brainstem, basal ganglia, internal capsule and optic radiation in a 2 months-old-boy. The findings were similar to MRI of live infants. In normal adult postmortem brains, the T1WI showed a relatively low signal intensity of white matter as compared to gray matter. The pictures were similar to proton density images, not T1WI of normal adult brains. The reason why the signal intensity of the white matter was lower than the gray matter may have been due to lysis of lipid of myelin sheath in the formalin solution. Postmortem MRI was able to detect the periventricular hyperintensity (corresponding to arteriosclerotic encephalopathy) and subcortical hyperintensity spots (which corresponding to the widening of the Virchow-Robin perivascular space because of arteriosclerosis) in the brains of our elderly patients. Postmortem MRI detected the intracerebral hemorrhage, which appeared as a dark signal in both short and long TR images. However, MRI did not show blood in the ventricles, sulci, or superficial hemorrhages in the cortex of brain. Brain edema was revealed in the postmortem MRI and appeared as low signal intensity in T1WI and hyperintensity in T2WI. It was associated with a significant mass effect.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[MRI of postmortem brains]. 820 68

The authors report two cases of hepatic encephalopathy with chronic hepatic failure. Case 1 was a 78-year-old woman with liver cirrhosis, admitted because of general fatigue and loss of appetite. Her electroencephalogram showed frequent slow waves in the theta range with intermittent triphasic waves T1-weighted MR images showed increased signal intensity in the globus pallidus and the putamen. Case 2 was a 71-year-old woman with chronic hepatitis, admitted because of depression. Her electroencephalogram showed frequent slow wave activities in the theta-delta range with intermittent trisphasic waves. Her serum ammonia level was 84 micrograms/dl (normal 12-54 micrograms/dl). T1-weighted MR images showed increased signal intensity in the globus pallidus, the putamen and the hypothalamus. On the basis of these findings, both patients were diagnosed as having hepatic encephalopathy, although disturbance of consciousness was not obvious. The observed MR image abnormalities might be due to the metabolic and pathological changes of chronic hepatic failure. Such MRI findings may be useful for the diagnosis of hepatic encephalopathy.
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PMID:[Two cases of hepatic encephalopathy associated with a high-intensity area in the basal ganglia on T1-weighted MR images]. 823 Jul 86

To show that Wilson's disease is one likely cause of multiple low-intensity nodules of the liver we obtained MR images in 16 patients with clinically and histopathologically confirmed Wilson's disease. Corresponding to morphological changes MRI enabled the subdivision of the patients into two groups. Using a T2-weighted spin-echo sequence (TR/TE = 2000/45-90) liver parenchyma showed multiple tiny low-intensity-nodules surrounded by high-intensity septa in 10 out of 16 patients. 5 patients had also low-intensity nodules in T1-weighted images (TR/TE = 600/20). In patients of this group histopathology revealed liver cirrhosis (n = 7) and fibrosis (n = 2). Common feature of this patient group was marked inflammatory cell infiltration into fibrous septa, increase of copper concentration in liver parenchyma and distinct pathological changes of laboratory data. In the remaining 6 patients no pathological change of liver morphology was demonstrated by MRI corresponding to slight histopathological changes of parenchyma and normal laboratory data. As low-intensity nodules surrounded by high intensity septa can be demonstrated in patients with marked inflammatory infiltration of liver parenchyma MRI may help to define Wilson patients with poorer prognosis. In patients with low-intensity nodules of the liver and unknown cause of liver cirrhosis laboratory data and histopathology should be checked when searching for disorders of copper metabolism.
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PMID:[MRT of the liver in Wilson's disease]. 830 91


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