Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Hepatocell Carcinoma. 2015 Jul 10;2:101-17. doi: 10.2147/JHC.S85201. eCollection 2015.
Cross-sectional imaging with computed tomography or magnetic resonance imaging is routinely used to detect and diagnose liver lesions; however, these examinations can provide additional important information. The improvement of equipment and techniques has allowed outstanding evaluation of the vascular and biliary anatomy, which is practicable in most routine examinations. Anatomical variants may exclude patients from certain therapeutic options and may be the cause of morbidity or mortality after surgery or interventional procedures. Diffuse liver disease, such as steatosis, hemochromatosis, or fibrosis, must be diagnosed and quantified. Usually these conditions are silent until the late stages, and imaging plays an important role in detecting them early. Additionally, a background of diffuse disease may interfere in a focal lesion systematic reasoning. The diagnostic probability of a particular nodule varies according to the background liver disease. Nowadays, most diffuse liver diseases can be easily and accurately quantified by imaging, which has allowed better understanding of these diseases and improved patient management. Finally, cross-sectional imaging can calculate total and partial liver volumes and estimate the future liver remnant after hepatectomy. This information helps to select patients for portal vein embolization and reduces postoperative complications. Use of a specific hepatic contrast agent on magnetic resonance imaging, in addition to improving detection and characterization of focal lesions, provides functional global and segmental information about the liver parenchyma.
计算机断层扫描或磁共振成像的横断面成像通常用于检测和诊断肝脏病变；然而，这些检查可以提供额外的重要信息。设备和技术的改进使得对血管和胆道解剖结构的评估变得非常出色，这在大多数常规检查中都是可行的。解剖变异可能会使某些治疗选择的患者排除在外，并可能导致手术或介入治疗后的发病率或死亡率。弥漫性肝脏疾病，如脂肪变性、血色病或纤维化，必须进行诊断和定量。通常这些疾病在晚期才会出现症状，而影像学在早期发现这些疾病方面发挥着重要作用。此外，弥漫性疾病的背景可能会干扰对局灶性病变的系统推理。特定结节的诊断概率根据肝脏疾病的背景而有所不同。如今，大多数弥漫性肝脏疾病都可以通过影像学轻松准确地定量，这使得人们对这些疾病有了更好的了解，并改善了患者的管理。最后，横断面成像可以计算全肝和肝段体积，并估计肝切除术后剩余肝脏的体积。这些信息有助于选择门静脉栓塞术的患者，并减少术后并发症。在磁共振成像上使用特定的肝对比剂除了提高对局灶性病变的检测和特征描述外，还提供了关于肝实质的整体和节段功能信息。
