RESUMEN
Gadoxetic acid is an MRI contrast agent that has specific applications in the study of hepatobiliary disease. After being distributed in the vascular and extravascular spaces during the dynamic phase, gadoxetic acid is progressively taken up by hepatocytes and excreted to the bile ducts during the hepatobiliary phase. The information derived from the enhancement characteristics during dynamic and hepatobiliary phases is particularly relevant in the detection and characterization of focal liver lesions and in the evaluation of the structure and function of the liver and biliary system. The use of new MRI sequences and advanced imaging techniques (eg, relaxometry, multiparametric imaging, and analysis of heterogeneity), the introduction of artificial intelligence, and the development of biomarkers and radiomic and radiogenomic tools based on gadoxetic acid-enhanced MRI findings will play an important role in the future in assessing liver function, chronic liver disease, and focal liver lesions; in studying biliary pathologic conditions; and in predicting treatment responses and prognosis. © RSNA, 2023 Quiz questions for this article are available in the supplemental material.
Asunto(s)
Medios de Contraste , Enfermedades del Sistema Digestivo , Gadolinio DTPA , Imagen por Resonancia Magnética , Humanos , Inteligencia Artificial , Carcinoma Hepatocelular , Medios de Contraste/administración & dosificación , Gadolinio DTPA/administración & dosificación , Enfermedades de la Vesícula Biliar , Neoplasias Hepáticas , Imagen por Resonancia Magnética/métodos , Estudios Retrospectivos , Sensibilidad y Especificidad , Enfermedades del Sistema Digestivo/diagnóstico por imagen , Técnicas de Diagnóstico del Sistema DigestivoRESUMEN
There is a wide range of benign liver tumors that behave in very different ways and require a management strategy specifically tailored to each. The most common benign solid liver tumor is hemangioma followed by focal nodular hyperplasia; the most common cystic tumor is the simple cyst. Most of these tumors are asymptomatic and are discovered as incidental findings on imaging tests performed for other reasons. Usually, no treatment or follow-up is required. The differential diagnosis with malignant liver tumors is sometimes difficult. This difficulty, together with the presence of symptoms or complications, is the main reason for surgical resection.
Asunto(s)
Adenoma/patología , Quistes/patología , Hiperplasia Nodular Focal/patología , Hemangioma/patología , Hepatopatías/patología , Neoplasias Hepáticas/patología , Adenoma/diagnóstico , Adenoma/epidemiología , Adenoma/genética , Adulto , Biomarcadores de Tumor , Carcinoma Hepatocelular/diagnóstico , Niño , Quistes/diagnóstico , Quistes/epidemiología , Diagnóstico Diferencial , Diagnóstico por Imagen , Femenino , Hiperplasia Nodular Focal/diagnóstico , Hiperplasia Nodular Focal/epidemiología , Hemangioma/diagnóstico , Hemangioma/epidemiología , Hepatectomía , Humanos , Hallazgos Incidentales , Hepatopatías/diagnóstico , Hepatopatías/epidemiología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/cirugía , Masculino , MutaciónRESUMEN
Entre los tumores hepáticos benignos se encuentra un amplio espectro de lesiones que se comportan de formas muy diversas y que, debido a esto, precisan una estrategia de tratamiento adaptada específicamente a cada uno de ellos. El tumor hepático benigno sólido más frecuente es el hemangioma seguido de la hiperplasia nodular focal, y el tumor quístico más frecuente es el quiste simple. La mayoría de estos tumores son asintomáticos, hallazgos casuales en pruebas de imagen realizadas por otros motivos, y generalmente no precisan tratamiento ni seguimiento. En ocasiones, el diagnóstico diferencial con tumores malignos hepáticos es difícil y esto constituye el principal motivo para la resección quirúrgica, así como la presencia de síntomas o complicaciones (AU)
There is a wide range of benign liver tumors that behave in very different ways and require a management strategy specifically tailored to each. The most common benign solid liver tumor is hemangioma followed by focal nodular hyperplasia; the most common cystic tumor is the simple cyst. Most of these tumors are asymptomatic and are discovered as incidental findings on imaging tests performed for other reasons. Usually, no treatment or follow-up is required. The differential diagnosis with malignant liver tumors is sometimes difficult. This difficulty, together with the presence of symptoms or complications, is the main reason for surgical resection (AU)