![]() In many cases a scan without contrast material is adequate for diagnosis. ![]() First, we evaluate the scan request for every patient to see if contrast material is needed at all. In this blog I will discuss the approach to these issues at UCSF. ![]() Patients with poor kidney function are the people at risk for these side effects. CT contrast materials do rarely cause kidney damage and a skin disorder called nephrogenic systemic fibrosis (NSF) can be caused by the MRI contrast agents. Contrast agents for both CT and MRI are an extremely safe group of drugs and adverse side effects rarely develop. Contrast agents help radiologists see some details on scans that are not visible otherwise. For many of these scans, contrast material is injected intravenously to complete the scan. The aim of our article was to review the current evidence on the usefulness of this new non-invasive diagnostic method in hepatic lesions.The following article was written by Ronald Zagoria, MD, FACR, Professor and Chief of Abdominal Imaging in the UCSF Department of Radiology and Biomedical Imaging.Īs a radiologist at UCSF, I commonly work with patients getting CT and MRI scans. In these last 2 settings, the complementary use of liver-specific contrast agents can be advantageous. Furthermore, if the lesion has a diameter < 1 cm, diagnosis is usually unreliable. However, in lesions measuring 1-2 cm, establishing the definitive diagnosis is a real challenge, with sensitivity values of 45-65%, but generally with excellent specificity (> 95%). They are more reliable in lesions > 2 cm. In regard to hepatocellular carcinoma, the diagnostic performance of magnetic resonance through the «conventional» protocols and multi-detector computerized tomography consisting of multiphase evaluation with intravenous contrast, largely depends on the size of the lesion. Gadolinium-enhanced magnetic resonance for the evaluation of hepatic lesions is increasingly being used in clinical practice, especially in patients with suspicious focal lesions, whether benign or malignant. El objetivo de este artículo es revisar la evidencia actual de la utilidad de este nuevo método de diagnóstico no invasivo en las lesiones hepáticas. En estos 2 últimos escenarios, el uso complementario de medios de contraste hepatoespecíficos puede ser útil. Además, si la lesión tiene un diámetro < 1 cm, el diagnóstico es generalmente poco fiable. Sin embargo, para aquellas lesiones de 1-2 cm, el establecimiento de un diagnóstico definitivo es un verdadero reto, con valores de sensibilidad del 45-65%, aunque por lo general con una excelente especificidad (> 95%). En el caso del carcinoma hepatocelular, el rendimiento diagnóstico de la resonancia magnética a través de protocolos «convencionales» y mediante la tomografía computarizada multidetector, que consiste en la evaluación de múltiples fases con contraste intravenoso, depende en gran medida del tamaño de la lesión, considerándose más certero en lesiones > 2 cm. La resonancia magnética con gadolinio para la evaluación de lesiones hepáticas es un método cada vez más utilizado en la práctica clínica, particularmente para pacientes con lesiones focales sospechosas, ya sean benignas o malignas.
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