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  • Hepatocellular carcinoma, CT, MR, US  (1)
  • Metastatic liver tumor  (1)
  • chronic hepatitis  (1)
  • 1
    ISSN: 1436-2813
    Keywords: major hepatectomy ; multiple regression analysis ; portal pressure ; aging ; liver cirrhosis ; chronic hepatitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The regenerative capacity of the liver was assessed using a volumetric method on computed tomography in 21 adults: 16 underwent a standard right hepatic lobectomy for hepatocellular carcinoma, there were hepatic metastases in 3 others, and 2 suffered from other diseases. The patients' ages ranged from 33 to 68 years with a mean age of 57.0 years. The regeneration rate was expressed as the rate of the volume increase of the remnant left lobe compared with the preoperative volume of the left lobe. A univariate regression analysis showed that the portal pressure had a highly inverse correlation with the regeneration rate of the liver (r = −0.4753,P = 0.0397), while a multiple regression analysis demonstrated the correlation between the portal pressure, age, and the regeneration rate (multipler = 0.5640). The regeneration rate of the normal liver (97.6 ± 53.5%) was significantly higher than that of the chronic hepatitic (43.0 ± 40.7%), and also tended to be higher than that of the cirrhotic liver (51.5 ± 13.2%). However, there were no differences between chronic hepatitic and cirrhotic livers. The portal pressure before hepatectomy of the normal liver (149 ± 19 mmH2O) was significantly lower than those of chronic hepatitic (188 ± 38 mmH2O) and cirrhotic (245 ±78 mmH2O) livers. We thus conclude that the regenerative capacity of the liver following a right hepatic lobectomy could be estimated on the basis of both portal pressure and age. The regenerative capacity was also influenced by underlying liver diseases.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1436-2813
    Keywords: Key Words Hepatic sclerosing hemangioma ; Metastatic liver tumor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present herein the case of a sclerosing hemangioma of the liver which was extremely difficult to differentiate from liver metastasis of rectal cancer, in a 67-year-old woman. All the radiological findings were compatible with liver metastasis; however, marginal pooling of the tumor revealed by computed tomographic angiography and magnetic resonance imaging scans was inconsistent with a diagnosis of liver metastasis. At laparotomy, the tumor was macroscopically unusual in that it was yellowish elastic-hard with a very clear margin, and thus, it did not have the appearance of a metastatic tumor. Mile's operation and a partial hepatectomy were performed, followed by an uneventful postoperative course and no signs of recurrence. The carcinoembryonic antigen (CEA) level in the peripheral blood was not elevated at any time. The postoperative pathological diagnosis was a rare hepatic tumor, namely, a "sclerosing hemangioma," based on the findings of cellular fibrous stroma containing vascular channels with flattened endothelial cells. Preoperatively differentiating between sclerosing hemangioma and a metastatic liver tumor from colorectal cancer may be very difficult; however, this case demonstrated some interesting characteristics, namely, the serum CEA level was not elevated, marginal pooling of the tumor was found in the enhanced radiological findings, and the tumor was macroscopically unusual. Therefore, the possibility of sclerosing hemangioma should be borne in mind when considering the differential diagnosis of patients suspected of having colorectal liver metastasis. A preoperative biopsy should be carried out and when a laparotomy is performed under the misdiagnosis of colorectal liver metastasis, it is advisable that either an intraoperative needle biopsy or a frozen histological analysis be undertaken to avoid unnecessary extended hepatic resection of this rare benign hepatic tumor.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0509
    Keywords: Liver, neoplasm ; Hepatocellular carcinoma, CT, MR, US
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The capabilities of computed tomography (CT), ultrasonography (US), and magnetic resonance (MR) imaging were studied in order to determine the role of each of these noninvasive examinations for estimating the T-factor of hepatocellular carcinomas (HCCs). Fifty-one patients with surgically proven HCCs received CT (50 patients), US (46 patients), and MR (44 patients). The images of CT, US, and MR were prospectively evaluated for main tumor size, intrahepatic metastases, and vascular invasion, which compose the T-factor of HCC, and compared to pathological results. The sizes of the main tumor were estimated correctly by all examinations. For estimating intrahepatic metastases, US (74%) and MR (73%) were superior to CT (65%). For estimating portal invasion, CT (79%) was superior to US (70%) and MR (66%), because CT could demonstrate the segmental staining caused by portal invasion. The estimates of hepatic venous invasion were difficult during any of the examinations. We conclude that presurgical evaluations of the T-factor require the use of US and CT or MR and CT.
    Type of Medium: Electronic Resource
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