By Tommaso Vincenzo Bartolotta, Adele Taibbi, Massimo Midiri
This ebook deals an image-based, entire quickly reference advisor that would help in the translation of contrast-enhanced ultrasound (CEUS) examinations of the liver in day-by-day perform. It describes and depicts general and abnormal habit of either universal and not more often saw focal liver lesions. for every kind of lesion, the findings on pre- and post-contrast photos are awarded and key features are highlighted. person chapters additionally specialize in the review of reaction to locoregional and systemic remedy and the influence of ecu instructions on CEUS. The Atlas of Contrast-Enhanced Sonography of Focal Liver Lesions will function a useful hands-on instrument for practitioners who have to diagnose liver lesions utilizing CEUS within the significant medical settings: oncology sufferers, cirrhotic sufferers, and sufferers with incidental focal liver lesions.
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Additional resources for Atlas of Contrast-enhanced Sonography of Focal Liver Lesions
8-cm-sized highly hypoechoic lesion located in segment VIII (arrow). (b) At color/pulsed-Doppler evaluation, the spoke-wheel sign is evident with low resistance index arterial signal (red arrow). (c) CEUS confirms the spoke-wheel aspect (arrow) in the early arterial phase. 4 Focal Nodular Hyperplasia c Fig. 13 (continued) 35 36 d Fig. 4 Focal Nodular Hyperplasia e Fig. 13 (continued) 37 38 f Fig. 4 Focal Nodular Hyperplasia 39 a b c d Fig. 14 Focal nodular hyperplasia in a 41-year-old woman. 4 cm-sized isoechoic lesion located in the IV segment (arrow) between middle and left suprahepatic veins (arrowheads).
In the abovementioned cases, differentiate HA from malignant lesions is quite hard, and further imaging workup or even biopsy may be required . 2 48 Benign Focal Liver Lesions a b Fig. 18 Biopsy-proved hepatocellular adenoma in a 37-year-old woman. 7 cm in the left lobe (calipers). (b) At pulsed-Doppler evaluation, some arterial vessel is evident within the mass. 5 Hepatocellular Adenoma c d Fig. 18 (continued) 49 50 e Fig. 6 Abscesses The liver abscesses are caused by pyogenic (85 %), fungal (9 %), or amebic (6 %) agents and can present as multiple lesions up to 50 % of cases, with variable size between few millimeters and several centimeters.
13 (continued) 37 38 f Fig. 4 Focal Nodular Hyperplasia 39 a b c d Fig. 14 Focal nodular hyperplasia in a 41-year-old woman. 4 cm-sized isoechoic lesion located in the IV segment (arrow) between middle and left suprahepatic veins (arrowheads). (b) At CEUS, during the arterial phase, the lesion presents a strong and homogeneous enhancement (arrow), and a feeding vessel is appreciable in the upper side (arrowhead). (c, d) The lesion becomes isovascular with respect to the surrounding liver parenchyma during the portal-venous (c) and late (d) phases 2 40 Benign Focal Liver Lesions a b Fig.