Zusammenfassung
Fokale Leberläsionen finden sich bei 5% der Gesamtbevölkerung. Da onkologische Erkrankungen hinsichtlich der Morbidität und der Mortalität der Bevölkerung eine wichtige Rolle spielen, kommt der Abklärung solch häufiger Befunde eine große Bedeutung zu. Nachdem im ersten Teil der Übersichtsdarstellung die auch für Radiologen wichtigsten Aspekte in der Klassifikation, Epidemiologie und Pathologie von Lebertumoren vermittelt und der aktuelle technische Stand der diagnostischen Verfahren erläutert wurden, beschäftigt sich der vorliegende zweite Teilbeitrag damit, die radiologischen Verfahren in ihrer Bedeutung für den Nachweis und die Differenzialdiagnose von Lebertumoren zu bewerten.
Abstract
Focal hepatic lesions occur in 5% of the population. The clarification of such common occurrences is of major significance because oncological diseases play an important role with respect to morbidity and mortality of the population. The first part of this review article dealt with the most important aspects of classification, epidemiology and pathology of hepatic tumors for radiologists and the current technical situation with regards to the diagnostic procedure. This second part of the review deals with the significance of radiological procedures for identification and differential diagnosis of hepatic tumors.
Literatur
Bartolozzi C, Donati F, Cioni D et al. (2004) Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT. Eur Radiol 14: 14–20
Bhartia B, Ward J, Guthrie JA et al. (2003) Hepatocellular carcinoma in cirrhotic livers: double-contrast thin-section MRI with pathologic correlation of explanted tissue. AJR Am J Roentgenol 180: 577–584
Bipat S, Van Leeuwen MS, Comans EF et al. (2005) Colorectal liver metastases: CT, MR imaging, and PET for diagnosis – meta-analysis. Radiology 237: 123–131
Buetow PC, Pantongrag-Brown L, Buck JL et al. (1996) Focal nodular hyperplasia of the liver: radiologic-pathologic correlation. Radiographics 16: 369–388
Colli A, Fraquelli M, Casazza G et al. (2006) Accuracy of ultrasonography, spiral CT, magnetic resonance, and alpha-fetoprotein in diagnosing hepatocellular carcinoma: a systematic review. Am J Gastroenterol 101: 513–523
De Lange EE, Mugler JP, Gay SB et al. (1996) Focal liver disease: comparison of breath-hold T1-weighted MP-GRE MR imaging and contrast-enhanced CT – lesion detection, localization, and characterization. Radiology 200: 465–473
Dietrich CF, Kratzer W, Strobe D et al. (2006) Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI. World J Gastroenterol 12: 1699–1705
Ferlicot S, Kobeiter H, Van Nhieu JT et al. (2004) MRI of atypical focal nodular hyperplasia of the liver: radiology-pathology correlation. AJR Am J Roentgenol 182: 1227–1231
Grazioli L, Morana G, Kirchin MA et al. (2005) Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study. Radiology 236: 166–177
Hagspiel KD, Neidl KFW, Eichenberger AC et al. (1995) Detection of liver metastases: comparison of supermagnatic iron oxide-enhanced and unenhanced MR imaging at 1.5 T with dynamic CT, intraoperative US, and percutaneous US. Radiology 196: 471–478
Helmberger H, Bautz W, Vogel U et al. (1993) CT-Arterioportographie in Spiraltechnik zum Nachweis von Lebermetastasen. Fortschr Röntgenstr 158: 410–415
Huppertz A, Balzer T, Blakeborough A et al. (2004) Improved detection of focal liver lesions at MRI: multicenter comparison of gadoxetic acid-enhanced MR images with intraoperative findings. Radiology 230: 266–275
Hussain SM, Van den Boos IC, Dwarkasing RS et al. (2006) Hepatocellular adenoma: findings at state-of-the-art magnetic resonance imaging, ultrasound, computed tomography and pathologic analysis. Eur Radiol 16: 1873–86
Irie T, Takeshita K, Wada Y et al. (1995) CT evaluation of hepatic tumors: comparison of CT wirth arterial portography, CT with infusion hepatic arteriography, and simultaneous of both techniques. Am J Roentgenol 164: 1407–1412
Kawamori Y, Matsui O, Takahashi S et al. (1996) Focal hepatic fatty infiltration in the posterior edge of the medial segment associated with aberrant gastric venous drainage: CT, US, and MR findings. J Comput Assist Tomogr 20: 356–359
Kim KW, Kim AY, Kim TK et al. (2004) Small (<2 cm) hepatic lesions in colorectal cancer patients: detection and characterization on Mangafodipir Trisodium-enhanced MRI. AJR Am J Roentgenol 182: 1233–1240
Kim YK, Kim CS, Lee YH et al. (2004) Comparison of superparamagnetic iron oxide-enhanced and gadobenate dimeglumine-enhanced dynamic MRI for detection of small hepatocellular carcinomas. AJR Am J Roentgenol 182: 1217–1223
Kim YK, Kim CS, Chung GH et al. (2006) Comparison of gadobenate diglumine-enhanced dynamic MRI and 16-MDCT for the detection of hepatocellular carcinoma. AJR Am J Roentgenol 186: 149–157
Kim YK, Kwak HS, Kim CS et al. (2006) Hepatocellular carcinoma in patients with chronic liver disease: comparison of SPIO-enhanced MR imaging and 16-detector row CT. Radiology 238: 531–541
Kinkel K, Lu Y, Both M et al. (2002) Detection of hepatic metastases from cancers of the gastrointestinal tract by using noninvasive imaging methods (US, CT, MR imaging, PET): a meta-analysis. Radiology 224: 748–756
Kreft B, Wolff M, Layer G et al. (1995) Bildgebende Diagnostik beim primären hepatobiliären Zystadenom der Leber. Aktuelle Radiol 5: 19–25
Layer G, Runge I, Conrad R et al. (1999) Portal kontrastverstärkte Spiral-Computertomographie der Leber – Korrelation radiologischer und intraoperativer Befunde und Beurteilung der Resektabilität. Fortschr Röntgenstr 171: 455–460
Lee HM, Lu DS, Krasny RM et al. (1997) Hepatic lesion characterization in cirrhosis: significance of arterial hypervascularity on dual-phase helical CT. Am J Roentgenol 169: 125–130
Onishi H, Murakami T, Kim T et al. (2006) Hepatic metastases: detection with multi-detector row CT, SPIO-enhanced MR imaging, and both techniques combined. Radiology 239: 131–138
Pauleit D, Textor J, Bachmann R et al. (2002) Hepatocellular carcinoma: detection with gadolinium- and ferrumoxides-enhanced MR imaging of the liver. Radiology 222: 73–80
Sahani Sahani D, Kalva SP, Tanabe KK et al. (2004) Intraoperative US in patients undergoing surgery for liver neoplasms: comparison with MR imaging. Radiology 232: 810–814
Seneterre E, Taourel P, Bouvier Y et al. (1996) Detection of hepatic metastases: ferrumoxides-enhanced MR imaging versus unenhanced MR imaging and CT during arterial portography. Radiology 200: 785–792
Spreafico C, Marchiano A, Mazzaferro V et al. (1997) Hepatocellular carcinoma in patients who undergo liver transplantation: sensitivity of CT with iodized oil. Radiology 203: 457–460
Tang Y, Yamashita Y, Arakawa A et al. (1999) Detection of hepatocellular carcinoma arising in cirrhotic livers: comparison of gadolinium- and ferumoxides-enhanced MR imaging. AJR Am J Roentgenol 172: 1547–54
Urhahn R, Adam G, Keulers P et al. (1996) Erkennbarkeit fokaler Leberläsionen: Vergleich von MRT bei 1,5 T und dynamischer Spiral-CT. Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 164: 301–307
Valls C, Cos M, Figueras J et al. (2004) Pretransplantation diagnosis and staging of hepatocellular carcinoma in patients with cirrhosis. Value of dual-phase helical CT. AJR Am J Roentgenol 182: 1011–1017
Ward J, Robinson PJ, Guthrie JA et al. (2005) Liver metastases in candidates for hepatic resection: comparison of helical CT and gadolinium- and SPIO-enhanced MR imaging. Radiology 237: 170–180
Yamamoto H, Yamashita Y, Yoshimatsu S et al. (1995) Hepatocellular carcinoma in cirrhotic livers: detection with unenhanced and iron oxide-enhanced MR imaging. Radiology 195: 106–112
Youk JH, Kim CS, Lee JMJ (2003) Contrast-enhanced agent detection imaging: value in the characterization of focal hepatic lesions. Ultrasound Med 22: 897–910
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Layer, G., Delorme, S. Radiologische Diagnostik von Lebertumoren. Radiologe 47, 919–934 (2007). https://doi.org/10.1007/s00117-007-1564-y
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DOI: https://doi.org/10.1007/s00117-007-1564-y