Evaluate the following multiphasic cross-sectional imaging descriptions of incidentally discovered solid liver lesions. Match each specific contrast-enhancement kinetic pattern observed on computed tomography (CT) or magnetic resonance imaging (MRI) with its most likely corresponding hepatic diagnosis.
- Arterial phase hyperenhancement with rapid contrast washout in the portal venous and delayed phases, often accompanied by an enhancing pseudocapsuleHepatocellular carcinoma
- Early discontinuous, peripheral nodular enhancement during the arterial phase, followed by progressive centripetal fill-in on delayed phasesHepatic hemangioma
- Intense, homogeneous enhancement during the arterial phase with a central hypointense region that demonstrates contrast retention and hyperintensity on delayed phasesFocal nodular hyperplasia
- Peripheral rim enhancement during the arterial phase with progressive, persistent delayed central enhancement, frequently associated with overlying hepatic capsular retractionIntrahepatic cholangiocarcinoma
Cevap
The correct matching pairs Hepatocellular carcinoma with arterial hyperenhancement and venous washout; Hepatic hemangioma with peripheral nodular centripetal fill-in; Focal nodular hyperplasia with arterial enhancement and a delayed-enhancing central scar; and Intrahepatic cholangiocarcinoma with progressive delayed enhancement and capsular retraction.
The non-invasive diagnosis of focal liver lesions relies heavily on understanding their distinct hemodynamic properties as captured by multiphasic contrast-enhanced imaging. The timing of contrast arrival, retention, and clearance (washout) relative to the normal liver parenchyma—which receives a unique dual blood supply from the portal vein and hepatic artery—provides pathognomonic signatures that often preclude the need for biopsy.
Adım Adım Çözüm
Anahtar Kavram
Multiphasic CT/MRI contrast enhancement kinetics of focal liver lesions