Diagnosis Of Hepatic Cysts Research Articles

EP06.19: Prenatal diagnosis of hepatic cyst: 2D, 3D and Doppler ultrasound features

EP06.19: Prenatal diagnosis of hepatic cyst: 2D, 3D and Doppler ultrasound features

Hepatic Cyst versus Hemangioma: Useful T2-FLAIR Image for Differentiation

OBJECTIVE: To study the concordance between diagnosis of hepatic cyst and hepatic hemangioma by using T2-FLAIR and multiphase contrasted MRI liver.MATERIALS AND METHODS: All cases for MRI liver who were diagnosed to be hepatic cyst and hepatic hemangioma by multiphase contrasted MRI liver and T2-FLAIR images form year 2014 to 2015 at Bangkok Hospital Headquarters, Bangkok, Thailand. The total 106 nodules were reviewed by two experienced radiologists and analyzed the new and previous reports for concordance and interpretation of the results.RESULTS: The new reports from T2-FLAIR images compared with report from contrasted MRI liver. The findings of the concordance to be hemangioma are 73 nodules and hepatic cysts for 32 nodules. There is only one nodule which is not corresponding. Hence, the concordance of these two studies is 99.05%.CONCLUSION: By using T2-FLAIR and contrasted MRI liver to differentiate of hepatic cysts and hemangioma, resulted in concordance of reading is 99.05%.

Diagnosis and treatment of nonparasitic hepatic cysts

The diagnosis of nonparasitic hepatic cysts has been significantly improved with the development of imaging techniques, however, the successful differential diagnosis depends on more careful consideration. The differential diagnosis of multiple hepatic cysts and polycystic liver disease depends on the family heredity, number of cysts, combination of polycystic kidney, division and the results of B ultrasound. The differential diagnosis of hepatic cyst and hepatic cystic adenocarcinoma depends on the imaging features and results of histopathological examination. Recently, laparoscopic surgery has been widespreadly used in the management of hepatic cystic disease, while it still cannot replace open surgery. The individualized and various treatment should be selected according to the condition of the patients. Key words: Hepatic cysts; Diagnosis; Therapy

Cystic Liver Metastases from Lung Adenocarcinoma: A Case Report

Cystic hepatic metastases arising from lung cancer are rare. We herein describe a case of a 71-year-old women admitted to our hospital for abdominal pain 6 months after the resection of a lung adenocarcinoma. Two cystic lesions of the liver were discovered at abdominal ultrasonography and computerized tomography scan. An ERCP excluded a biliary adenoma or adenocarcinoma, and an ultrasound-guided liver biopsy was negative for malignant cells. For persistence of symptoms and lack of a diagnosis, the patient underwent an exploratory laparotomy, a surgical biopsy with a diagnosis of adenocarcinoma, and a consequent right hepatectomy. After 2 years of follow-up, the patient is well and disease free. Although cystic liver metastasis are rare and a differential diagnosis difficult, the malignant nature should always be considered in the differential diagnosis of hepatic cysts to offer the patient the best treatment.

Single-stage transthoracic approach for right lung and liver hydatid disease

Objective:Human echinococcosis remains a serious health problem for the Mediterranean countries. Synchronous pulmonary and hepatic hydatid disease may occur in 4% to 25% of cases. Our experience on simultaneous surgical treatment of right lung and liver hydatid disease in patients was reviewed. MethodsBetween 1990 and 2000, 48 patients (33 female patients and 15 male patients) with synchronous right lung and liver dome hydatid cysts were operated with a 1-stage procedure. ResultsSix patients had previous surgical treatment of hepatic (n = 2) or pulmonary (n = 4) hydatid cyst. The pulmonary cysts were diagnosed with radiography in 18 patients and thoracic computed tomography scan in 30. The pulmonary cysts of 9 patients were bilateral. Seventy-five pulmonary cysts were seen in radiological examinations. The diagnosis of hepatic cysts was established with ultrasonography in 18 patients and upper abdominal computed tomography in 30. The total number of hepatic cysts was 48. In cases with pulmonary cysts, cystotomy and capitonnage were performed in 32 patients, only cystotomy was done in 14 patients, and wedge resection was performed in 2. Liver cysts were approached to transdiaphragmatically after the lung cysts had been dealt with and were managed with evacuation of the cysts. In the remaining cases, marsupialization (n = 2), pericystectomy (n = 1), and enucleation (n = 1) were performed. Major postoperative complications were hemorrhage (n = 1) and biliocutaneous fistula (n = 1). Hepatic recurrence was seen in 3 patients (6.2%) and pulmonary recurrence in 1 (2.1%). ConclusionTransthoracic approach is a useful and a safe surgical management of both pulmonary and upper surface of hepatic hydatid cysts.

Prenatal ultrasonic diagnosis of hepatic cyst

A case of non-parasitic hepatic cyst is presented that was diagnosed in utero by ultrasonography. Postnatal ultrasound and computed tomography confirmed the diagnosis. At laparotomy, the cyst was dissected free from the liver. The postoperative course was uneventful. Prenatal diagnosis enables elective surgery to be performed, preventing future complications.

Pitfalls in the diagnosis of hepatic cysts by computed tomography.

Seven patients with computed tomographic (CT) evidence of cystic hepatic lesions are presented. In these cases, CT could not reliably distinguish benign hepatic cysts from other intrahepatic and extrahepatic cystic lesions. The attenuation coefficients of simple cysts and inflammatory or neoplastic lesions were similar, and smooth margins occurred in all three of these conditions. It was not possible to visualize and differentiate lesion walls from the surrounding normal hepatic parenchyma in some cases. It is concluded that the specificity of CT in the differentiation of benign cysts and other lesions is lower in the liver than it is in other areas, such as the kidney, and that in cases of diagnostic uncertainty, biopsy should be performed.