Subscribe to RSS
DOI: 10.1055/s-2004-818768
Diagnostik fokaler Leberläsionen: CT, MRT, PET etc.
Diagnostics of Focal Hepatic Lesions: CT, MRI, PET etc.
Zusammenfassung
Fokale Leberläsionen sind unabhängig vom Vorhandensein eines Malignoms ein häufiger Befund. Für ein eventuelles therapeutisches Management ist es dabei erforderlich, die Läsionen eindeutig zu identifizieren und zu charakterisieren. Zur nicht-invasiven Diagnostik stehen die Sonographie, Computertomographie (CT), Magnetresonanztomographie (MRT) und nuklearmedizinische Verfahren zur Verfügung. Die modernen chirurgischen wie auch minimalinvasiven ablativen Verfahren erfordern eine hohe diagnostische Präzision, die insbesondere von der CT und MRT gewährleistet wird. Darüber hinaus gewinnt die Positronenemissionstomographie (PET) gerade beim Staging und der Therapiekontrolle zunehmend an Bedeutung, was umso mehr für die kombinierten PET-CT Scanner gilt, die die hohe Sensitivität der PET mit der Ortsauflösung der CT vereinen.
Bei der Abklärung fokaler Leberläsionen müssen neben der Leistungsfähigkeit der einzelnen Untersuchungsmethoden das Spektrum möglicher Läsionen im Kontext der jeweiligen Grunderkrankung des Patienten berücksichtigt werden.
Abstract
Independently from the presence of a malignant disease focal hepatic lesions are a common finding. For a potential therapeutical management it is mandatory to identify and characterize precisely the lesions. For non-invasive diagnostics ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear scintigraphy are available. Current surgical and minimally invasive ablative techniques necessitate a high diagnostic precision, maintained especially by CT and MRI. Moreover, positron emission tomography (PET) yields increasingly importance mainly in staging and therapy control what is also true for the new combined PET-CT scanners which combine the high sensitivity of PET with the high spatial resolution of CT.
In the work-up of focal hepatic disease the potential of the diverse imaging modalities as well as the spectrum of the various lesions together with the findings of the underlying disease of the patient has to be considered.
Publication History
Publication Date:
21 April 2004 (online)
© 2004. Thieme. All rights reserved.
Georg Thieme Verlag Stuttgart · New York
-
Literatur
- 1
Karhunen PJ.
Benign hepatic tumours and tumour like conditions in men.. J Clin Pathol 1986; 39:
183-188
MissingFormLabel
- 2
Jones EC,
Chezmar JL,
Nelson RC,
Bernardino ME.
The frequency and significance of small (less than or equal to 15 mm) hepatic lesions
detected by CT.. AJR Am J Roentgenol 1992; 158: 535-539
MissingFormLabel
- 3
Hagspiel KD,
Neidl KF,
Eichenberger AC,
Weder W,
Marincek B.
Detection of liver metastases: comparison of superparamagnetic iron oxide-enhanced
and unenhanced MR imaging at 1.5 T with dynamic CT, intraoperative US, and percutaneous
US.. Radiology 1995; 196: 471-478
MissingFormLabel
- 4
Fusai G,
Davidson BR.
Management of colorectal liver metastases.. Colorectal Dis 2003; 5: 2-23
MissingFormLabel
- 5
Gazelle GS,
Hunink MG,
Kuntz KM.
et al
Cost-effectiveness of hepatic metastasectomy in patients with metastatic colorectal
carcinoma: a state-transition Monte Carlo decision analysis.. Ann Surg 2003; 237:
544-555
MissingFormLabel
- 6
Benson 3rd AB,
Choti MA,
Cohen AM.
et al
NCCN Practice Guidelines for Colorectal Cancer.. Oncology (Huntingt) 2000; 14: 203-212
MissingFormLabel
- 7
Neumaier CE,
Cittadini G,
Grasso A,
Dahmane M.
Role of ultrasonography in the staging of gastrointestinal neoplasms.. Semin Surg
Oncol 2001; 20: 86-90
MissingFormLabel
- 8
Glover C,
Douse P,
Kane P.
et al
Accuracy of investigations for asymptomatic colorectal liver metastases.. Dis Colon
Rectum 2002; 45: 476-484
MissingFormLabel
- 9
Delorme S,
van Kaick G.
[Cui bono? Comments on cost-benefit analysis in ultrasound diagnosis].. Radiologe
1996; 36: 285-291
MissingFormLabel
- 10
Hamm B.
[Cost benefit considerations in modern diagnostic sectional imaging exemplified by
upper abdominal organs].. Radiologe 1996; 36: 292-299
MissingFormLabel
- 11
Kahn T.
[Value of CT and MRI in malignant hepatobiliary tumors].. Zentralbl Chir 2000; 125:
610-615
MissingFormLabel
- 12
Fenchel S,
Fleiter TR,
Merkle EM.
Multislice helical CT of the abdomen.. Eur Radiol 2002; 12 (Suppl. 02) S 5-S 10
MissingFormLabel
- 13
Itoh S,
Ikeda M,
Achiwa M.
et al
Multiphase contrast-enhanced CT of the liver with a multislice CT scanner.. Eur Radiol
2003; 13: 1085-1094
MissingFormLabel
- 14
Vogl TJ,
Schwarz W,
Blume S.
et al
Preoperative evaluation of malignant liver tumors: comparison of unenhanced and SPIO
(Resovist)-enhanced MR imaging with biphasic CTAP and intraoperative US.. Eur Radiol
2003; 13: 262-272
MissingFormLabel
- 15
Helmberger T,
Semelka RC.
New contrast agents for imaging the liver.. Magn Reson Imaging Clin N Am 2001; 9:
745-766
MissingFormLabel
- 16
Semelka RC,
Helmberger TK.
Contrast agents for MR imaging of the liver.. Radiology 2001; 218: 27-38
MissingFormLabel
- 17
Rummeny EJ,
Marchal G.
Liver imaging. Clinical applications and future perspectives.. Acta Radiol 1997; 38:
626-630
MissingFormLabel
- 18
Helmberger T,
Gregor M,
Holzknecht N.
et al
[Effects of biphasic spiral CT, conventional and iron oxide enhanced MRI on therapy
and therapy costs in patients with focal liver lesions].. Rofo Fortschr Geb Rontgenstr
Neuen Bildgeb Verfahr 2000; 172: 251-259
MissingFormLabel
- 19
Ward J,
Guthrie JA,
Wilson D.
et al
Colorectal hepatic metastases: detection with SPIO-enhanced breath-hold MR imaging
- comparison of optimized sequences.. Radiology 2003; 228: 709-718
MissingFormLabel
- 20
Seneterre E,
Taourel P,
Bouvier Y.
et al
Detection of hepatic metastases: ferumoxides-enhanced MR imaging versus unenhanced
MR imaging and CT during arterial portography.. Radiology 1996; 200: 785-792
MissingFormLabel
- 21
Ward J,
Naik KS,
Guthrie JA,
Wilson D,
Robinson PJ.
Hepatic lesion detection: Comparison of MR imaging after administration of superparamagnetic
Iron Oxide with dual-phase CT by using alternative-free response receiver operating
characteristic analysis.. Radiology 1999; 210: 459-466
MissingFormLabel
- 22
Neumann MC,
Schober O.
[Nuclear medicine diagnosis of the liver].. Radiologe 2000; 40: 916-924
MissingFormLabel
- 23
Reske SN,
Kotzerke J.
FDG-PET for clinical use. Results of the 3rd German Interdisciplinary Consensus Conference,
“Onko-PET III”, 21 July and 19 September 2000.. Eur J Nucl Med 2001; 28: 1707-1723
MissingFormLabel
- 24
Kinkel K,
Lu Y,
Both M,
Warren RS,
Thoeni RF.
Detection of hepatic metastases from cancers of the gastrointestinal tract by using
noninvasive imaging methods (US, CT, MR imaging, PET): a meta-analysis.. Radiology
2002; 224: 7487-56
MissingFormLabel
- 25
Balzer JO,
Luboldt W,
Vogl TJ.
[Importance of CT and MRI in the follow-up of patients with rectal cancer].. Radiologe
2003; 43: 122-127
MissingFormLabel
- 26
Trotter JF,
Everson GT.
Benign focal lesions of the liver.. Clin Liver Dis 2001; 5: 17-42
MissingFormLabel
- 27
Mortele KJ,
Ros PR.
Benign liver neoplasms.. Clin Liver Dis 2002; 6: 119-145
MissingFormLabel
- 28
Biecker E,
Fischer HP,
Strunk H,
Sauerbruch T.
Benign hepatic tumours.. Z Gastroenterol 2003; 41: 191-200
MissingFormLabel
- 29
Jang HJ,
Kim TK,
Lim HK.
et al
Hepatic hemangioma: atypical appearances on CT, MR imaging, and sonography.. AJR Am
J Roentgenol 2003; 180: 35-141
MissingFormLabel
- 30
Vilgrain V,
Uzan F,
Brancatelli G.
et al
Prevalence of hepatic hemangioma in patients with focal nodular hyperplasia: MR imaging
analysis.. Radiology 2003; 229: 75-79
MissingFormLabel
- 31
De Rave S,
Hussain SM.
A liver tumour as an incidental finding: differential diagnosis and treatment.. Scand
J Gastroenterol Suppl. 2002; 81-86
MissingFormLabel
- 32
Grimm J,
Muller-Hulsbeck S,
Blume J,
Biederer J,
Heller M.
[Comparison of biphasic spiral CT and MnDPDP-enhanced MRI in the detection and characterization
of liver lesions].. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 2001; 173:
266-272
MissingFormLabel
- 33
Noguchi Y,
Murakami T,
Kim T.
et al
Detection of hepatocellular carcinoma: comparison of dynamic MR imaging with dynamic
double arterial phase helical CT.. AJR Am J Roentgenol 2003; 180: 455-460
MissingFormLabel
- 34
Verhoef C,
Valkema R,
de Man RA,
Krenning EP,
Yzermans JN.
Fluorine-18 FDG imaging in hepatocellular carcinoma using positron coincidence detection
and single photon emission computed tomography.. Liver 2002; 22: 51-56
MissingFormLabel
- 35
Yucel C,
Ozdemir H,
Gurel S,
Ozer S,
Arac M.
Detection and differential diagnosis of hepatic masses using pulse inversion harmonic
imaging during the liver-specific late phase of contrast enhancement with Levovist..
J Clin Ultrasound 2002; 30: 203-212
MissingFormLabel
- 36
Schillaci O,
Spanu A,
Scopinaro F.
et al
Somatostatin receptor scintigraphy in liver metastasis detection from gastroenteropancreatic
neuroendocrine tumors.. J Nucl Med 2003; 44: 359-368
MissingFormLabel
- 37
Shimada M,
Takenaka K,
Gion T.
et al
Treatment strategy for patients with cystic lesions mimicking a liver tumor: a recent
10-year surgical experience in Japan.. Arch Surg 1998; 133: 643-646
MissingFormLabel
- 38
Fusai G,
Davidson BR.
Strategies to Increase the Resectability of Liver Metastases from Colorectal Cancer..
Dig Surg 2003; 20: 481-496
MissingFormLabel
- 39
Muller RD,
Vogel K,
Neumann K.
et al
[MRI with supermagnetic iron particles versus double-spiral CT in identification of
malignant liver lesions].. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 1998;
168: 436-443
MissingFormLabel