Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘liver’ Category

Liver metastasis differential

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Hypervascular Liver Metastases
  • RCC
  • Carcinoid
  • Islet cell
  • melanoma
  • thyroid
  • choriocarcinoma
  • Ovarian cystadenocarcinoma
  • pheochromocytoma
Hypovascular Liver Metastases
  • Stomach
  • Colon
  • Pancreas
  • Lung
  • Breast
Hemorrhagic Liver Metastases
  • Colon
  • Thyroid
  • Breast
  • Choriocarcinoma
  • Melanoma
  • RCC
Calcified Liver Mets
  • Mucinous tumors

Dahnert

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Written by lmwong

August 15, 2010 at 12:22 pm

Posted in abdomen, differential, gi, liver

Liver mass in children

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  • Hemangioendothelioma (MC B9)
    • <6 months
    • cutaneous hemangiomas
  • Mesenchymal Hamartoma
    • <10 y
    • large, multiloculated
    • exophytic
  • Hepatoblastoma (MC malignant)
    • Beckwith-Wiedeman syndrome
    • hemihypertrophy
    • mets
  • HCC
    • glycogen storage disease
    • biliary atresia
    liver masses in pediatrics

Written by lmwong

March 9, 2010 at 11:33 am

Couinard’s Liver Segments

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Written by lmwong

January 14, 2010 at 7:44 am

Posted in abdomen, gi, liver

Liver Laceration Grading

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Grade 1 (either or)

  • Subcapsular hematoma <1cm
  • Liver Laceration <1cm deep

Grade 2 SH or LLĀ 1-3 cm

Grade 3 SH or LL >3cm

Grade 4 LL or SH >10cm Lobar destruction devascularization

Grade 5 Global destruction or devascularization

Grade 6 Hepatic avulsion

Written by lmwong

January 14, 2010 at 7:28 am

Posted in abdomen, gi, liver, trauma

Choledocal cyst

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  • congenital focal or diffuse dilation of bile ducts
  • females
  • 5 categories
    • type 1 cysts
      • 80-90%
      • saccular or fusiform
    • type 2
      • diverticula of duct
    • type 3
      • choledochoceles
      • dilation of terminal, intraduodenal portion of CBD
    • type 4
      • intrahepatic and extrahepatic cysts
    • type 5 = Caroli’s disease
      • multiple cystic dilations of the intrahepatic bile ducts
      • ~ medullary sponge kidney, AR PCKD
      • complications: liver abscess, portal vein thrombosis, biliary cirrhosis with portal hypertension
      • 100% risk of cholangiocarcinoma
      • MRCP, cholangiography, ERCP shows biliary origins of cysts
  • marked biliary stasis: get infection, inflammation, stone disease
  • risk of cholangiocarcinoma with age
  • in neonates, disorder ~ extrahepatic biliary atresia
  • Rx: surgical resection (Kasai procedure: portoenterostomy)

    Written by lmwong

    January 9, 2010 at 9:40 am

    Posted in abdomen, cystic, gi, liver

    Cavernous transformation of portal vein

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    • long standing portal hypertension from portal thrombosis
      • causes of portal thrombosis
        • HCC
        • cirrhosis
        • pancreatitis
        • hypercoagulable states
        • splenectomy
    • dilated periportal veins
    • collaterals run along free edge of less omentum
    • flow is hepatopedal or bidirectional

    Written by lmwong

    January 9, 2010 at 9:32 am

    Posted in abdomen, gi, liver

    Budd Chiari Syndrome

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    • partial or complete obstruction of one or more hepatic veins or IVC
    • no flow or reversed flow on US/Doppler in hepatic veins
    • causes
      • idiopathic
      • tumor thrombus
      • pregnancy
      • hypercoagulation states
      • trauma
      • sepsis
      • dehydration

    Written by lmwong

    January 9, 2010 at 9:28 am

    Posted in abdomen, gi, liver