By Tommaso Vincenzo Bartolotta, Adele Taibbi, Massimo Midiri
This e-book deals an image-based, finished speedy reference consultant that may help in the translation of contrast-enhanced ultrasound (CEUS) examinations of the liver in day-by-day perform. It describes and depicts usual and peculiar habit of either universal and no more often saw focal liver lesions. for every kind of lesion, the findings on pre- and post-contrast pictures are provided and key features are highlighted. person chapters additionally concentrate on the review of reaction to locoregional and systemic remedy and the impression of ecu instructions on CEUS. The Atlas of Contrast-Enhanced Sonography of Focal Liver Lesions will function a useful hands-on instrument for practitioners who have to diagnose liver lesions utilizing CEUS within the significant scientific settings: oncology sufferers, cirrhotic sufferers, and sufferers with incidental focal liver lesions.
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Additional resources for Atlas of Contrast-enhanced Sonography of Focal Liver Lesions
4 Focal Nodular Hyperplasia d Fig. 12 (continued) 33 2 34 Benign Focal Liver Lesions a b Fig. 13 Focal nodular hyperplasia in a 35-year-old woman. 8-cm-sized highly hypoechoic lesion located in segment VIII (arrow). (b) At color/pulsed-Doppler evaluation, the spoke-wheel sign is evident with low resistance index arterial signal (red arrow). (c) CEUS confirms the spoke-wheel aspect (arrow) in the early arterial phase. 4 Focal Nodular Hyperplasia c Fig. 13 (continued) 35 36 d Fig. 4 Focal Nodular Hyperplasia e Fig.
19 Hepatic abscess in a 47-year-old woman with fever. (a) Central ascending subcostal baseline image reveals an inhomogeneous hyperechoic lesion with small central fluid area sized 4 cm in the IV hepatic segment (calipers) without any vascular signal at color-Doppler evaluation (b). 6 Abscesses d Fig. 19 (continued) 53 54 2 Benign Focal Liver Lesions a b Fig. 20 Abscess in a 56-year-old woman with fever after biopsy. 2 cm in the VII hepatic segment without any vascular signal at colorDoppler evaluation (arrow).
18 Biopsy-proved hepatocellular adenoma in a 37-year-old woman. 7 cm in the left lobe (calipers). (b) At pulsed-Doppler evaluation, some arterial vessel is evident within the mass. 5 Hepatocellular Adenoma c d Fig. 18 (continued) 49 50 e Fig. 6 Abscesses The liver abscesses are caused by pyogenic (85 %), fungal (9 %), or amebic (6 %) agents and can present as multiple lesions up to 50 % of cases, with variable size between few millimeters and several centimeters. Classic pyogenic abscesses show rounded or oval morphology, with 51 a thick hyperechoic wall, partially fluid content, with septa and sometimes gas and fluid levels in the context.