RESUMEN
Computed tomographic (CT) and magnetic resonance (MR) appearances of bile duct adenoma (BDA in a patient who underwent partial hepatectomy of segment 8 are presented. BDA showed a ring-shaped hyperdense area suggesting calcification and ring enhancement on CT. It appeared hypointense on both T1- and T2-weighted MR images. Preoperatively, the diagnoses considered included metastatic carcinoma, cholangiocarcinoma, tuberculosis, and rare tumors such as epithelioid hemangioendothelioma. The radiological findings were confirmed by pathological investigation.
Asunto(s)
Adenoma de los Conductos Biliares/diagnóstico , Neoplasias de los Conductos Biliares/diagnóstico , Conductos Biliares Intrahepáticos/patología , Calcinosis/diagnóstico , Imagen por Resonancia Magnética , Adenoma de los Conductos Biliares/diagnóstico por imagen , Adenoma de los Conductos Biliares/patología , Adenoma de los Conductos Biliares/cirugía , Anciano , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Conductos Biliares Intrahepáticos/diagnóstico por imagen , Conductos Biliares Intrahepáticos/cirugía , Calcinosis/diagnóstico por imagen , Calcinosis/cirugía , Diagnóstico Diferencial , Femenino , Hepatectomía , Humanos , Tomografía Computarizada por Rayos XRESUMEN
Percutaneous radiofrequency (RF) ablation is feasible for the treatment of unresectable hepatocellular carcinoma, and experience at the authors' institution during 5 years indicates that percutaneous RF ablation can be performed safely in most cases. However, early or late complications related to mechanical or thermal damage may be observed at follow-up examination. Complications may be classified in three groups: vascular (eg, portal vein thrombosis, hepatic vein thrombosis with partial hepatic congestion, hepatic infarction, and subcapsular hematoma), biliary (eg, bile duct stenosis and biloma, abscess, and hemobilia), and extrahepatic (eg, injury to the gastrointestinal tract, injury to the gallbladder, pneumothorax and hemothorax, and tumor seeding). Most complications can be managed with conservative treatment, percutaneous or endoscopic drainage, or surgical repair. Because an early and accurate diagnosis is necessary for proper management, radiologists should be familiar with the imaging features of each type of complication.
Asunto(s)
Carcinoma Hepatocelular/cirugía , Ablación por Catéter/efectos adversos , Neoplasias Hepáticas/cirugía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/terapia , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND AND PURPOSE: T1-weighted spin-echo imaging has been widely used to study anatomic detail and abnormalities of the brain; however, the image contrast of this technique is often poor, especially at low field strengths. We tested a new pulse sequence, T1-weighted fluid-attenuated inversion recovery (FLAIR), which provides good contrast between lesions, surrounding edematous tissue, and normal parenchyma at low field strengths and at acquisition times comparable to those of T1-weighted spin-echo imaging. METHODS: Thirteen patients with brain lesions underwent T1-weighted spin-echo and T1-weighted FLAIR imaging during the same imaging session. T1-weighted spin-echo and T1-weighted FLAIR images were compared on the basis of four quantitative (lesion-white matter [WM] contrast-to-noise ratio [CNR], lesion-CSF CNR, gray matter-WM CNR, and WM-CSF CNR) and three qualitative criteria (conspicuousness of lesions, image artifacts, and overall image contrast). RESULTS: CNRs obtained with T1-weighted FLAIR were comparable but statistically superior to those obtained with T1-weighted spin-echo imaging. In general, T1-weighted FLAIR and T1-weighted spin-echo imaging produced comparable image artifacts. Conspicuousness of lesions and the overall image contrast were judged to be superior on T1-weighted FLAIR images. CONCLUSION: T1-weighted FLAIR imaging may be a valuable alternative to conventional T1-weighted imaging, because the former technique offers superior image contrast at low field strengths and comparable acquisition times.