Hepatocarcinoma fibrolamelar un tumor de adultos jóvenes poco frecuente. . Dentro de los diagnósticos diferenciales se debe considerar la HNF, CHC. Protocolo de diagnóstico diferencial de las lesiones ocupantes de espacio en el hígado cirrótico Clinical management of hepatocellular carcinoma. Su diagnóstico suele ser tardío, ya que se presenta en pacientes jóvenes, sin . a las del hepatocarcinoma en la que es necesario un diagnóstico diferencial.

Author: Mobar Digar
Country: Georgia
Language: English (Spanish)
Genre: Technology
Published (Last): 4 April 2010
Pages: 329
PDF File Size: 7.20 Mb
ePub File Size: 7.92 Mb
ISBN: 207-7-99413-488-5
Downloads: 70576
Price: Free* [*Free Regsitration Required]
Uploader: Arashizshura

So, hepatobiliary contrast agents combine the pharmacodynamic features of extracellular gadolinium usual dynamic study with the delayed hepatobiliary phase, adding functional information to the MRI study and enhancing its diagnoztico accuracy 124 – 6.

Fibrolamellar hepatocellular carcinoma: a case report

Please review our privacy policy. However, in cases of advanced cirrhosis, the contrast uptake by the liver parenchyma may be compromised by decreased hepatocytes function, which would result in reduction of the method’s accuracy to detect HCCs 4 The use of hepatobiliary contrast agents increases the diagnostic accuracy of magnetic resonance imaging and reduces the number of non-specific liver lesions.

At conventional MRI, hemangiomas present marked hypersignal on T2-weighted, hyposignal on T1-weighted sequences, discontinuous, nodular, peripheral contrast enhancement in the arterial phase, tending to centripetal fill-in by the contrast agent in the subsequent phases 13 Open in a separate window.

As a result, the healthy hepatic tissue remains hyperintense and the metastasis, hypointense, which facilitates its detection 12.

Diffusion- and T2-weighted sequences may be acquired after hepatobiliary contrast agent injection, considering that there is no significant interference effect. Phase II trial of systemic continuous fluorouracil and subcutaneous recombinant interferon Alfa-2b for treatment of hepatocellular carcinoma.


Considering that the presence of intralesional fat in NFH is rare, the patient will be maintained under imaging follow-up. How to cite this article. The pharmacokinetics and doses of gadobenate dimeglumine and gadoxetic acid are different.

Thus, high-grade dysplastic nodules tend to be hypovascular in the arterial and portal phases, but may also become hypervascular in the arterial phase in cases where the abnormal arterial vascularization is more developed. European journal of surgical oncology: The presence of central scar markedly hyperintense on T2-weighted and hypointense on T1-weighted sequences, with no contrast uptake in the arterial phase and late diterencial uptake is typical.

Patients with advanced liver and kidney diseases alternatively compensate the contrast agents clearance by renal or biliary excretion, respectively. The differentiation between HCC diferencual perfusion alterations may also represent a diagnostic challenge.

The doses recommended for intravenous injection of such contrast agents are also different, corresponding to 0. The metastatic implants that do not contain hepatocytes become hypointense. In summary, hepatobiliary contrast increases the MRI accuracy and reduces the number of cases of undefined liver lesions.

Abstract The characterization of focal liver lesions is very important. Further potential hepatobiliary contrast applications include evaluation of the functional hepatic reserve before partial hepatectomy; evaluation of live donor’s hepatic function as well as evaluation of early liver failure after transplant.

There was a problem providing the content you requested

Sonographic morphometry of the liver and biliary tract in porcine models submitted to experimental biliary obstruction. Adverse effects of hepatobiliary contrast agents rarely occur and, if present, are similar to the ones reported in the use of extra-cellular gadolinium.


Rarely, there difeerencial hepatobiliary contrast uptake by adenomas and, in cases where it occurs, such an uptake tends to be preferentially peripheral in the hepatobiliary phase 124. The characterization of focal liver lesions is yepatocarcinoma important. High-grade dysplastic nodules contain functioning hepatocytes and also demonstrate hepatobiliary contrast uptake in the same way as the surrounding parenchyma Figure 5.

The imaging evaluation of the biliary system has been approached by a series of publications in the Brazilian radiological literature 24 – Benign liver lesions are frequently found, even in patients with known neoplasia.

Case Report of Fibrolamellar Hepatocarcinoma, a Rare Tumor of Young Adults

Hepatology ; 39 3: Note the capacity of hepatobiliary contrast to detect very small lesions which cannot be visualized on the other sequences. As gadobenate dimeglumine is utilized, it is recommended that the MRI study be performed as usual, including the dynamic study up to the delayed phase; then the procedure be interrupted and the patient returns after minutes for acquisition of the hepatobiliary phase.

Reporte de un caso. Additionally, hepatobiliary contrast agents contribute to the diagnosis of small, benign focal lesions frequently found in patients with neoplasias, particularly FNH Figure 8. The diagnostic performance of MRI in the detection of HCCs of all sizes increases with the utilization of hepatobiliary contrast agents 1 Vilgrain V, Vullierme MP.