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Figure 14. Focal nodular hyperplasia (FNH). The infused CT (a) performed for abdominal trauma in this 32 year old woman shows an isodense mass in the lateral segment of the left lobe of the liver (arrows). A central hypodense area suggests the central scar of FNH. Transverse (b) and coronal (c) 99mTc-sulfur colloid SPECT images show greater activity in the lesion (arrowheads) compared with normal liver confirming the diagnosis of FNH.

Figure 14. Focal nodular hyperplasia (FNH). The infused CT (a) performed for abdominal trauma in this 32 year old woman shows an isodense mass in the lateral segment of the left lobe of the liver (arrows). A central hypodense area suggests the central scar of FNH. Transverse (b) and coronal (c) 99mTc-sulfur colloid SPECT images show greater activity in the lesion (arrowheads) compared with normal liver confirming the diagnosis of FNH.

fibrolamellar variant of HCC, may have an otherwise normal liver. In that situation HCC often presents as a nonspecific vascular mass. A high proportion of advanced tumours will have portal vein thrombosis in the absence of portal vein compression.

99mTc-sulfur colloid imaging is useful in evaluation of a liver distorted by cirrhosis. Mass like areas that accumulate colloid represent localized areas of hypertrophy or regenerating nodules. Areas of absent colloid activity that accumulate gallium or some other marker of metabolic activity likely represent hepatoma (Fig. 4). Since close to 90% of all hepatomas accumulate gallium to some degree, simultaneous 99mTc-sulfur colloid subtraction yields the greatest sensitivity. In the absence of cirrhosis, the technique is less specific and other gallium-avid tumours cannot be differentiated.

On 99mTc-IDA imaging, the level of uptake by the HCC reflects the level of differentiation and greater accumulation carries a better prognosis. Well-differentiated HCC however cannot be differentiated from HA with confidence. Elevated alpha-fetoprotein supports a diagnosis of HCC.

Focal Fatty infiltration and Sparing

Fatty infiltration of the liver is seen with alcohol abuse, obesity, diabetes mellitus and other disorders of metabolism. Increased fat content results in hyperechogenicity on US and decreased density on CT. In some cases the fat deposition is nonuniform with areas of focal fatty infiltration or focal fatty sparing. The focally altered echogenicity on US or density on CT may be difficult to distinguish from metastases.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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