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State-of-the-art cross-sectional liver imaging: beyond lesion detection and characterization

Authors Luersen G, Bhosale P, Szklaruk J

Received 21 March 2015

Accepted for publication 22 April 2015

Published 10 July 2015 Volume 2015:2 Pages 101—117

DOI https://doi.org/10.2147/JHC.S85201

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Ahmed O Kaseb

Gustavo Felipe Luersen, Priya Bhosale, Janio Szklaruk

Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Abstract: Cross-sectional imaging with computed tomography or magnetic resonance imaging is routinely used to detect and diagnose liver lesions; however, these examinations can provide additional important information. The improvement of equipment and techniques has allowed outstanding evaluation of the vascular and biliary anatomy, which is practicable in most routine examinations. Anatomical variants may exclude patients from certain therapeutic options and may be the cause of morbidity or mortality after surgery or interventional procedures. Diffuse liver disease, such as steatosis, hemochromatosis, or fibrosis, must be diagnosed and quantified. Usually these conditions are silent until the late stages, and imaging plays an important role in detecting them early. Additionally, a background of diffuse disease may interfere in a focal lesion systematic reasoning. The diagnostic probability of a particular nodule varies according to the background liver disease. Nowadays, most diffuse liver diseases can be easily and accurately quantified by imaging, which has allowed better understanding of these diseases and improved patient management. Finally, cross-sectional imaging can calculate total and partial liver volumes and estimate the future liver remnant after hepatectomy. This information helps to select patients for portal vein embolization and reduces postoperative complications. Use of a specific hepatic contrast agent on magnetic resonance imaging, in addition to improving detection and characterization of focal lesions, provides functional global and segmental information about the liver parenchyma.

Keywords: cirrhosis, steatosis, iron overload, vascular anatomy, biliary anatomy, functional liver remnant

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