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By Guy Marchal MD (auth.), Andreas Heuck MD, Maximilian Reiser MD (eds.)

ISBN-10: 3540672168

ISBN-13: 9783540672166

ISBN-10: 3642181945

ISBN-13: 9783642181948

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Rarely they can be symptomatic due to infection or bleeding, or produce pain due to a mass effect which may necessitate surgical therapy. Radiologic differentiation of simple hepatic cysts from other primary or secondary liver tumors is not difficult. When a hepatic cyst is suspected, an ultrasound examination must first be performed. On ultrasonography, hepatic cysts are anechoic (GAINES and SAMPSON 1989). Since they do not attenuate the ultrasound beam, the posterior wall is well seen and there is enhanced through-transmission.

However, highly vascularized or cystic metastases, such as those from endocrine tumors (islet cell), pheochromocytomas, carcinoids, sarcomas and carcinoma, also show persistence of high signal intensity on delayed echo images. Usually, metastases have slightly irregular margins which distinguish them from the mostly Fig. 1. A T2-weighted fast spin-echo sequence shows the sharp margins of cysts or small hemangiomas. On typical appearance of a malignant lesion with heterogeneous T2-weighted sequences, malignant lesions tend to signal intensity (large arrows).

6). While no secondary liver tumors are known to enhance, several other primary liver tumors such as well-differentiated hepatocellular carcinoma, regenerative nodular hyperplasia, and hepatocellular adenoma also enhance (ROFSKY et al. 1993; RUMMENY et al. 1991b; MURAKAMI et al. 1996). Recently several groups have shown that superparamagnetic iron oxide (SPIO)-enhanced MRI can be helpful in the diagnosis of FNH. Because of RES cells within the tumor, FNH shows uptake of SPIO that parallels uptake of technetium-99m sulfur colloid in nuclear medicine (GRANDIN et al.

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Abdominal and Pelvic MRI by Guy Marchal MD (auth.), Andreas Heuck MD, Maximilian Reiser MD (eds.)

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