Daniella Parente | Universidade Federal do Rio de Janeiro (UFRJ) (original) (raw)
Papers by Daniella Parente
Scientific Reports
To evaluate the diagnostic value of described thresholds of controlled attenuation parameter (CAP... more To evaluate the diagnostic value of described thresholds of controlled attenuation parameter (CAP) and biomarker scores for liver steatosis and to evaluate new cut-offs to detect moderate-to-severe steatosis (S2–3) in patients with morbid obesity. In this prospective study, 32 patients with morbid obesity with indications for bariatric surgery (15 women and 17 men, mean age = 36 years, median BMI = 40.2 kg/m2) underwent CAP, magnetic resonance spectroscopy (MRS), three biomarker scores (Steato-ELSA, Fatty Liver Index (FLI), and Hepatic Steatosis Index (HSI)), and liver biopsy. Subjects were divided into an exploratory cohort (reliable CAP and liver biopsy) and a confirmatory cohort (reliable CAP and MRS) to evaluate new thresholds for CAP and biomarker scores to detect S2–3. Receiver operator characteristic (ROC) curves analyses were performed and the optimal cut-off points were identified using the maximal Youden index. A total of 22 patients had CAP measure and liver biopsy (explo...
Cardiology in the Young
Introduction: Tuberous sclerosis complex is a rare genetic disorder leading to the growth of hama... more Introduction: Tuberous sclerosis complex is a rare genetic disorder leading to the growth of hamartomas in multiple organs, including cardiac rhabdomyomas. Children with symptomatic cardiac rhabdomyoma require frequent admissions to intensive care units, have major complications, namely, arrhythmias, cardiac outflow tract obstruction and heart failure, affecting the quality of life and taking on high healthcare cost. Currently, there is no standard pharmacological treatment for this condition, and the management includes a conservative approach and supportive care. Everolimus has shown positive effects on subependymal giant cell astrocytomas, renal angiomyolipoma and refractory seizures associated with tuberous sclerosis complex. However, evidence supporting efficacy in symptomatic cardiac rhabdomyoma is limited to case reports. The ORACLE trial is the first randomised clinical trial assessing the efficacy of everolimus as a specific therapy for symptomatic cardiac rhabdomyoma. Meth...
Radiologia Brasileira
Objective: To evaluate liver lesions, in accordance with the LI-RADS classification, using contra... more Objective: To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists. Materials and Methods: We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) . Results: Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23...
Radiologia Brasileira
A 57-year-old male patient with Rendu-Osler-Weber syndrome presented to the emergency department ... more A 57-year-old male patient with Rendu-Osler-Weber syndrome presented to the emergency department with a 24-h history of lumbar pain. A computed tomography scan of the abdomen showed liver alterations typical of the syndrome (telangiectasias, shunts, and arteriovenous malformations), which is also known as hereditary hemorrhagic telangiectasia. The examination showed opacification of the hepatic veins in the early arterial phase-a consequence of the arteriovenous shunts (Figure 1A). We observed heterogeneous opacification of the portal vein during the portal phase, with more pronounced enhancement in the intrahepatic branches-a result of portal venous shuntas well as numerous prominent vessels near the hepatic hilum, corresponding to an arteriovenous malformation (Figure 1B). We also observed a confluent vascular mass, measuring 1.4 cm, located in segment II (Figure 1C). In addition, there were extensive areas of altered perfusion in the hepatic parenchyma, in a mosaic pattern, as well as increased caliber of the hepatic artery
Radiologia Brasileira
the adenoma. To our knowledge, there have been no previous reports of this complication. The trea... more the adenoma. To our knowledge, there have been no previous reports of this complication. The treatment of pyogenic liver abscess includes intravenous antibiotic therapy and percutaneous drainage guided by ultrasound or CT. Acute or elective TAE seems to be a safe procedure for the management of HCA. Because of its minimally invasive and parenchyma-preserving properties, together with its ability to reduce the size of tumors located at anatomical sites that make surgery difficult, elective TAE offers a reasonable alternative to surgery.
Clinical Case Reports
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Frontline Gastroenterology
Gastroenterology, Jan 5, 2017
Question: A 56-year-old man with celiac disease presented to the emergency room with intermittent... more Question: A 56-year-old man with celiac disease presented to the emergency room with intermittent fever for the last month. There was no history of cough, urinary symptoms, or abdominal pain. He had a recent right colectomy for adenocarcinoma. His physical examination was unremarkable. Laboratory investigation showed anemia, and negative blood and urine cultures. Initial investigation with a postcontrast computed tomography scan of the abdomen showed multiple, coalescent, rim-enhancing, round cystic lesions with low-attenuation in the root of the small bowel mesentery (Figure A, arrows); some of them showed fat attenuation (Figure A, arrowheads). To better evaluate the findings, magnetic resonance imaging was performed. Axial T2-weighted magnetic resonance imaging demonstrated several cystic masses in root of mesentery with marked hyperintense signal (Figure B, arrows), some with fat-fluid levels (Figure B, arrowheads). Axial fatsuppressed T1-weighted image shows signal intensity consistent with fat inside the cystic lesions (Figure C, arrows), with fat-fluid levels (Figure C, arrowheads). What are the differential diagnoses? Look on page 16 for the answer and see the Gastroenterology website (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and images in GI.
Radiologia brasileira
The aim of this pictorial essay is to review the spectrum of fat-containing liver lesions and the... more The aim of this pictorial essay is to review the spectrum of fat-containing liver lesions and their characterisation on magnetic resonance imaging with focus on the radiological features that aid in the differential diagnoses. Fat-containing liver lesions comprise a heterogeneous group of tumours with variable imaging findings. Magnetic resonance imaging clearly displays the micro- and macroscopic fat components of the lesions and other characteristic features that are helpful tools to make the differential diagnosis.
Diagnostic and interventional radiology (Ankara, Turkey), Jan 21, 2018
We aimed to evaluate the ADNEX MR scoring system for the prediction of adnexal mass malignancy, u... more We aimed to evaluate the ADNEX MR scoring system for the prediction of adnexal mass malignancy, using a simplified magnetic resonance imaging (MRI) protocol. In this prospective study, 200 patients with 237 adnexal masses underwent MRI between February 2014 and February 2016 and were followed until February 2017. Two radiologists calculated ADNEX MR scores using an MRI protocol with a simplified dynamic study, not a high temporal resolution study, as originally proposed. Sensitivity, specificity, positive and negative predictive values, likelihood ratios, and the area under the receiver operating characteristic curve were calculated (cutoff for malignancy, score ≥ 4). The reference standard was histopathologic diagnosis or imaging findings during >12 months of follow-up. Of 237 lesions, 79 (33.3%) were malignant. The ADNEX MR scoring system, using a simplified MRI protocol, showed 94.9% (95% confidence interval [CI], 87.5%-98.6%) sensitivity and 97.5% (95% CI, 93.6%-99.3%) specif...
Radiologia Brasileira, Jun 1, 2012
Linfoma de colo uterino é uma doença rara. Cerca de 1,0% a 1,5% dos linfomas extranodais se origi... more Linfoma de colo uterino é uma doença rara. Cerca de 1,0% a 1,5% dos linfomas extranodais se origina no trato genital feminino. A apresentação clínica é inespecífica e a ressonância magnética é importante para a suspeita diagnóstica. Neste artigo relatamos o caso de uma paciente de 80 anos de idade com dor lombar, cuja ressonância mostrou volumosa massa uterina. O diagnóstico final foi de linfoma.
Radiologia Brasileira, 2008
Radiologia Brasileira, 2015
PURPOSE/AIM 1. To demonstrate the diagnostic value of CT and MR imaging in the evaluation of the ... more PURPOSE/AIM 1. To demonstrate the diagnostic value of CT and MR imaging in the evaluation of the therapeutic response of HCC to TACE. 2. To illustrate typical and atypical CT and MR imaging appearances of HCC after TACE. 3. To review the imaging pitfalls and future perspectives on assessment of residual/recurrent disease. CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: - CT and MRI protocols - Review of imaging findings: typical and atypical CT and MR imaging appearances of HCC after TACE - Strategy of follow-up study after TACE - Potential pitfalls - Future perspectives: Diffusion-weigthed (DW) imaging and hepatic perfusion with dynamic MR SUMMARY 1. Rim enhancement caused by granulation tissue can be seen at the periphery of treated lesions, a finding that has to be differentiated from residual tumor. 2. MR examination is superior to CT scan on the evaluation of enhancement areas (viable tumor) 3. DW imaging and he...
PURPOSE/AIM 1. To review the spectrum of fat-containing lesions of the liver. 2. To explain the u... more PURPOSE/AIM 1. To review the spectrum of fat-containing lesions of the liver. 2. To explain the utility of MRI and particularly in/out-of-phase and other fat-saturation techniques to characterize the fat component of the lesions. 3. To recognize the radiologic features of fat-containing liver lesions that help in the differential diagnosis. CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: 1. MRI protocols 2. Fat-containing liver lesions: - Focal fatty change (steatosis) - Geographic fatty change (steatosis) - Diffuse steatosis with focal fatty sparing - Hepatic adenoma - Hepatocellular carcinoma - Pseudolipoma of the Glisson capsule - Lipoma - Angiomyolipoma - Focal nodular hyperplasia - Metastatic teratoma - Cystic teratoma SUMMARY • Fat-containing liver tumors comprise a heterogeneous group of tumors with variable imaging findings. • MR is able to identify both microscopic and macroscopic fat components in the lesio...
PURPOSE/AIM The purpose of this exhibit is: 1. To review the spectrum of hypervascular lesions th... more PURPOSE/AIM The purpose of this exhibit is: 1. To review the spectrum of hypervascular lesions that can occur in cirrhotic liver and the diagnostic value of MR imaging 2. To recommend a follow-up strategy to indeterminate lesions. 3. To discuss future perspectives: DW imaging as a potential sequence CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: - MRI protocols - HCC: a multistep process - Spectrum of hypervascular lesions in cirrhotic liver: low-grade displastic nodule high-grade displastic nodule dysplastic nodule with microscopic foci of HCC small HCC HCC nontumorous arterially enhancing nodules perfusion defects hemangioma focal nodular hyperplasia hepatic adenoma fibrosis SUMMARY 1. Familiarity with the multistep process that occurs in the development of HCC and its imaging findings is essential to permit accurate diagnosis. 2. Criteria favoring malignancy are size larger than 2 cm, delayed hypointensity "...
PURPOSE/AIM 1. To recognize CT and MR imaging characteristics that help in the differential diagn... more PURPOSE/AIM 1. To recognize CT and MR imaging characteristics that help in the differential diagnosis between pancreatic pseudocysts and cystic neoplasms. 2. To explain the utility of MRCP on lesion characterization. 3. To discuss future perspectives: DW imaging as a potential sequence 4. To discuss the role of endoscopic US. CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: 1. CT and MR / MRCP protocols - advantages and limitations of each method 2. Spectrum of cystic pancreatic lesions – sample of cases: - Pancreatic Pseudocyst - Cystic Neoplasms - Serous Cystadenoma - Mucinous Cystic Neoplasms - Intraductal Papillary Mucinous Tumor - Solid and Papillary Epithelial Neoplasm 3. Future directions: DW imaging 4. Role of Endoscopic US SUMMARY • Cystic pancreatic lesions comprise a heterogeneous group of disorders with variable imaging findings. • The use of adequate CT and MR / MRCP protocols and the knowledge of the ima...
PURPOSE/AIM 1. To review the anatomy of hepatic capsular/subcapsular regions and understand the l... more PURPOSE/AIM 1. To review the anatomy of hepatic capsular/subcapsular regions and understand the liver hemodynamic alterations 2. To review and illustrate the various capsular and subcapsular liver lesions and recognize the pitfalls and difficulties in imaging interpretation CONTENT ORGANIZATION 1.Introduction 2.Anatomy of capsular/subcapsular liver region-hemodynamic considerations 3.Pathologic conditions (CT and MRI) a.Infectious/Inflammatory- perihepatitis, tuberculosis b.Neoplastic- metastasis, cholangiocarcinoma c.Pseudolesions/Benign lesions related to altered liver hemodynamic- third flow, AV shunt, thrombosis, infarction, fatty infiltration/sparing d.Miscellaneous lesions- confluent fibrosis,post-surgical findings, pseudolipoma of the Glisson capsule 4.Summary SUMMARY 1. Many pathologic conditions can appear as capsular/subcapsular liver lesions or pseudolesions. 2. Knowledge of the pathologic conditions, pseudolesions and their imaging findings is important for an accurate d...
Scientific Reports
To evaluate the diagnostic value of described thresholds of controlled attenuation parameter (CAP... more To evaluate the diagnostic value of described thresholds of controlled attenuation parameter (CAP) and biomarker scores for liver steatosis and to evaluate new cut-offs to detect moderate-to-severe steatosis (S2–3) in patients with morbid obesity. In this prospective study, 32 patients with morbid obesity with indications for bariatric surgery (15 women and 17 men, mean age = 36 years, median BMI = 40.2 kg/m2) underwent CAP, magnetic resonance spectroscopy (MRS), three biomarker scores (Steato-ELSA, Fatty Liver Index (FLI), and Hepatic Steatosis Index (HSI)), and liver biopsy. Subjects were divided into an exploratory cohort (reliable CAP and liver biopsy) and a confirmatory cohort (reliable CAP and MRS) to evaluate new thresholds for CAP and biomarker scores to detect S2–3. Receiver operator characteristic (ROC) curves analyses were performed and the optimal cut-off points were identified using the maximal Youden index. A total of 22 patients had CAP measure and liver biopsy (explo...
Cardiology in the Young
Introduction: Tuberous sclerosis complex is a rare genetic disorder leading to the growth of hama... more Introduction: Tuberous sclerosis complex is a rare genetic disorder leading to the growth of hamartomas in multiple organs, including cardiac rhabdomyomas. Children with symptomatic cardiac rhabdomyoma require frequent admissions to intensive care units, have major complications, namely, arrhythmias, cardiac outflow tract obstruction and heart failure, affecting the quality of life and taking on high healthcare cost. Currently, there is no standard pharmacological treatment for this condition, and the management includes a conservative approach and supportive care. Everolimus has shown positive effects on subependymal giant cell astrocytomas, renal angiomyolipoma and refractory seizures associated with tuberous sclerosis complex. However, evidence supporting efficacy in symptomatic cardiac rhabdomyoma is limited to case reports. The ORACLE trial is the first randomised clinical trial assessing the efficacy of everolimus as a specific therapy for symptomatic cardiac rhabdomyoma. Meth...
Radiologia Brasileira
Objective: To evaluate liver lesions, in accordance with the LI-RADS classification, using contra... more Objective: To evaluate liver lesions, in accordance with the LI-RADS classification, using contrast-enhanced multiphase dynamic computed tomography in patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, as well as to determine the level of agreement between radiologists. Materials and Methods: We evaluated 38 patients with hepatitis B, coinfected or not with hepatitis D, or with chronic hepatitis C, all of whom underwent contrast-enhanced multiphase dynamic computed tomography. For each examination, two radiologists selected up to three hepatic lesions, categorizing them in accordance with the LI-RADS classification and evaluating signs of chronic liver disease and portal hypertension. To determine the level of agreement between radiologists, we calculated the kappa statistic (κ) . Results: Radiologist 1 and radiologist 2 selected 56 and 48 liver lesions, respectively. According to radiologist 1 and radiologist 2, respectively, 27 (71%) and 23...
Radiologia Brasileira
A 57-year-old male patient with Rendu-Osler-Weber syndrome presented to the emergency department ... more A 57-year-old male patient with Rendu-Osler-Weber syndrome presented to the emergency department with a 24-h history of lumbar pain. A computed tomography scan of the abdomen showed liver alterations typical of the syndrome (telangiectasias, shunts, and arteriovenous malformations), which is also known as hereditary hemorrhagic telangiectasia. The examination showed opacification of the hepatic veins in the early arterial phase-a consequence of the arteriovenous shunts (Figure 1A). We observed heterogeneous opacification of the portal vein during the portal phase, with more pronounced enhancement in the intrahepatic branches-a result of portal venous shuntas well as numerous prominent vessels near the hepatic hilum, corresponding to an arteriovenous malformation (Figure 1B). We also observed a confluent vascular mass, measuring 1.4 cm, located in segment II (Figure 1C). In addition, there were extensive areas of altered perfusion in the hepatic parenchyma, in a mosaic pattern, as well as increased caliber of the hepatic artery
Radiologia Brasileira
the adenoma. To our knowledge, there have been no previous reports of this complication. The trea... more the adenoma. To our knowledge, there have been no previous reports of this complication. The treatment of pyogenic liver abscess includes intravenous antibiotic therapy and percutaneous drainage guided by ultrasound or CT. Acute or elective TAE seems to be a safe procedure for the management of HCA. Because of its minimally invasive and parenchyma-preserving properties, together with its ability to reduce the size of tumors located at anatomical sites that make surgery difficult, elective TAE offers a reasonable alternative to surgery.
Clinical Case Reports
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Frontline Gastroenterology
Gastroenterology, Jan 5, 2017
Question: A 56-year-old man with celiac disease presented to the emergency room with intermittent... more Question: A 56-year-old man with celiac disease presented to the emergency room with intermittent fever for the last month. There was no history of cough, urinary symptoms, or abdominal pain. He had a recent right colectomy for adenocarcinoma. His physical examination was unremarkable. Laboratory investigation showed anemia, and negative blood and urine cultures. Initial investigation with a postcontrast computed tomography scan of the abdomen showed multiple, coalescent, rim-enhancing, round cystic lesions with low-attenuation in the root of the small bowel mesentery (Figure A, arrows); some of them showed fat attenuation (Figure A, arrowheads). To better evaluate the findings, magnetic resonance imaging was performed. Axial T2-weighted magnetic resonance imaging demonstrated several cystic masses in root of mesentery with marked hyperintense signal (Figure B, arrows), some with fat-fluid levels (Figure B, arrowheads). Axial fatsuppressed T1-weighted image shows signal intensity consistent with fat inside the cystic lesions (Figure C, arrows), with fat-fluid levels (Figure C, arrowheads). What are the differential diagnoses? Look on page 16 for the answer and see the Gastroenterology website (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and images in GI.
Radiologia brasileira
The aim of this pictorial essay is to review the spectrum of fat-containing liver lesions and the... more The aim of this pictorial essay is to review the spectrum of fat-containing liver lesions and their characterisation on magnetic resonance imaging with focus on the radiological features that aid in the differential diagnoses. Fat-containing liver lesions comprise a heterogeneous group of tumours with variable imaging findings. Magnetic resonance imaging clearly displays the micro- and macroscopic fat components of the lesions and other characteristic features that are helpful tools to make the differential diagnosis.
Diagnostic and interventional radiology (Ankara, Turkey), Jan 21, 2018
We aimed to evaluate the ADNEX MR scoring system for the prediction of adnexal mass malignancy, u... more We aimed to evaluate the ADNEX MR scoring system for the prediction of adnexal mass malignancy, using a simplified magnetic resonance imaging (MRI) protocol. In this prospective study, 200 patients with 237 adnexal masses underwent MRI between February 2014 and February 2016 and were followed until February 2017. Two radiologists calculated ADNEX MR scores using an MRI protocol with a simplified dynamic study, not a high temporal resolution study, as originally proposed. Sensitivity, specificity, positive and negative predictive values, likelihood ratios, and the area under the receiver operating characteristic curve were calculated (cutoff for malignancy, score ≥ 4). The reference standard was histopathologic diagnosis or imaging findings during >12 months of follow-up. Of 237 lesions, 79 (33.3%) were malignant. The ADNEX MR scoring system, using a simplified MRI protocol, showed 94.9% (95% confidence interval [CI], 87.5%-98.6%) sensitivity and 97.5% (95% CI, 93.6%-99.3%) specif...
Radiologia Brasileira, Jun 1, 2012
Linfoma de colo uterino é uma doença rara. Cerca de 1,0% a 1,5% dos linfomas extranodais se origi... more Linfoma de colo uterino é uma doença rara. Cerca de 1,0% a 1,5% dos linfomas extranodais se origina no trato genital feminino. A apresentação clínica é inespecífica e a ressonância magnética é importante para a suspeita diagnóstica. Neste artigo relatamos o caso de uma paciente de 80 anos de idade com dor lombar, cuja ressonância mostrou volumosa massa uterina. O diagnóstico final foi de linfoma.
Radiologia Brasileira, 2008
Radiologia Brasileira, 2015
PURPOSE/AIM 1. To demonstrate the diagnostic value of CT and MR imaging in the evaluation of the ... more PURPOSE/AIM 1. To demonstrate the diagnostic value of CT and MR imaging in the evaluation of the therapeutic response of HCC to TACE. 2. To illustrate typical and atypical CT and MR imaging appearances of HCC after TACE. 3. To review the imaging pitfalls and future perspectives on assessment of residual/recurrent disease. CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: - CT and MRI protocols - Review of imaging findings: typical and atypical CT and MR imaging appearances of HCC after TACE - Strategy of follow-up study after TACE - Potential pitfalls - Future perspectives: Diffusion-weigthed (DW) imaging and hepatic perfusion with dynamic MR SUMMARY 1. Rim enhancement caused by granulation tissue can be seen at the periphery of treated lesions, a finding that has to be differentiated from residual tumor. 2. MR examination is superior to CT scan on the evaluation of enhancement areas (viable tumor) 3. DW imaging and he...
PURPOSE/AIM 1. To review the spectrum of fat-containing lesions of the liver. 2. To explain the u... more PURPOSE/AIM 1. To review the spectrum of fat-containing lesions of the liver. 2. To explain the utility of MRI and particularly in/out-of-phase and other fat-saturation techniques to characterize the fat component of the lesions. 3. To recognize the radiologic features of fat-containing liver lesions that help in the differential diagnosis. CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: 1. MRI protocols 2. Fat-containing liver lesions: - Focal fatty change (steatosis) - Geographic fatty change (steatosis) - Diffuse steatosis with focal fatty sparing - Hepatic adenoma - Hepatocellular carcinoma - Pseudolipoma of the Glisson capsule - Lipoma - Angiomyolipoma - Focal nodular hyperplasia - Metastatic teratoma - Cystic teratoma SUMMARY • Fat-containing liver tumors comprise a heterogeneous group of tumors with variable imaging findings. • MR is able to identify both microscopic and macroscopic fat components in the lesio...
PURPOSE/AIM The purpose of this exhibit is: 1. To review the spectrum of hypervascular lesions th... more PURPOSE/AIM The purpose of this exhibit is: 1. To review the spectrum of hypervascular lesions that can occur in cirrhotic liver and the diagnostic value of MR imaging 2. To recommend a follow-up strategy to indeterminate lesions. 3. To discuss future perspectives: DW imaging as a potential sequence CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: - MRI protocols - HCC: a multistep process - Spectrum of hypervascular lesions in cirrhotic liver: low-grade displastic nodule high-grade displastic nodule dysplastic nodule with microscopic foci of HCC small HCC HCC nontumorous arterially enhancing nodules perfusion defects hemangioma focal nodular hyperplasia hepatic adenoma fibrosis SUMMARY 1. Familiarity with the multistep process that occurs in the development of HCC and its imaging findings is essential to permit accurate diagnosis. 2. Criteria favoring malignancy are size larger than 2 cm, delayed hypointensity "...
PURPOSE/AIM 1. To recognize CT and MR imaging characteristics that help in the differential diagn... more PURPOSE/AIM 1. To recognize CT and MR imaging characteristics that help in the differential diagnosis between pancreatic pseudocysts and cystic neoplasms. 2. To explain the utility of MRCP on lesion characterization. 3. To discuss future perspectives: DW imaging as a potential sequence 4. To discuss the role of endoscopic US. CONTENT ORGANIZATION The most important imaging findings in each heading bellow will be illustrated and discussed: 1. CT and MR / MRCP protocols - advantages and limitations of each method 2. Spectrum of cystic pancreatic lesions – sample of cases: - Pancreatic Pseudocyst - Cystic Neoplasms - Serous Cystadenoma - Mucinous Cystic Neoplasms - Intraductal Papillary Mucinous Tumor - Solid and Papillary Epithelial Neoplasm 3. Future directions: DW imaging 4. Role of Endoscopic US SUMMARY • Cystic pancreatic lesions comprise a heterogeneous group of disorders with variable imaging findings. • The use of adequate CT and MR / MRCP protocols and the knowledge of the ima...
PURPOSE/AIM 1. To review the anatomy of hepatic capsular/subcapsular regions and understand the l... more PURPOSE/AIM 1. To review the anatomy of hepatic capsular/subcapsular regions and understand the liver hemodynamic alterations 2. To review and illustrate the various capsular and subcapsular liver lesions and recognize the pitfalls and difficulties in imaging interpretation CONTENT ORGANIZATION 1.Introduction 2.Anatomy of capsular/subcapsular liver region-hemodynamic considerations 3.Pathologic conditions (CT and MRI) a.Infectious/Inflammatory- perihepatitis, tuberculosis b.Neoplastic- metastasis, cholangiocarcinoma c.Pseudolesions/Benign lesions related to altered liver hemodynamic- third flow, AV shunt, thrombosis, infarction, fatty infiltration/sparing d.Miscellaneous lesions- confluent fibrosis,post-surgical findings, pseudolipoma of the Glisson capsule 4.Summary SUMMARY 1. Many pathologic conditions can appear as capsular/subcapsular liver lesions or pseudolesions. 2. Knowledge of the pathologic conditions, pseudolesions and their imaging findings is important for an accurate d...