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Solitary Necrotic Nodules of the Liver: Histology and Diagnosis With CT and MRI

AUTHORS

Li Xia Wang 1 , Kan Liu 2 , Guang Wu Lin 3 , * , Ren You Zhai 1 , *

AUTHORS INFORMATION

1 Department of Radiology, Beijing Chaoyang Hospital, Capital University of Medical Sciences, renyouzhai@126.com, China

2 Department of Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China

3 Department of Radiology, Huadong Hospital, Fudan University, Lin010002000@yahoo.com.cn, China

Corresponding Authors:

ARTICLE INFORMATION

Hepatitis Monthly: 12 (8); 6212
Published Online: August 20, 2012
Article Type: Research Article
Received: May 14, 2012
Accepted: June 9, 2012
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Abstract

Background: A solitary necrotic nodule (SNN) of the liver is an uncommon lesion, which is different from primary and metastatic liver cancers.

Objectives: To analyze the classification, CT and MR manifestation, and the pathological basis of solitary necrotic nodule of the liver (SNN) in order to evaluate CT and MRI as a diagnosing tool.

Patients and Methods: This study included 29 patients with liver SNNs, out of which 14 had no clinical symptoms and were discovered by routine ultrasound examinations, six were found by computed tomography (CT) due to abdominal illness, four had ovarian tumors, and five had gastrointestinal cancer surgeries, previously. Histologically, these SNNs can be divided into three subtypes, i.e., type I, pure coagulation necrosis (14 cases); type II, coagulation necrosis mixed with liquefaction necrosis (five cases); and type III, multi-nodular fusion (10 cases). CT and magnetic resonance imaging (MRI) patterns were shown to be associated with SNN histology. All patients were treated surgically with good prognosis.

Results: CT and MRI appearance and correlation with pathology types: three subtypes of lesions were hypo-density on both pre contrast and post contrast CT, 12 lesions were found the enhanced capsule and 1 lesion of multi- nodular fusion type showed septa enhancement. The lesions were hypo-intensity on T2WI and the lesions of type II showed as mixed hyperintensity on T2WI. The capsule showed delayed enhancement in all cases, and all lesions of multi- nodular fusion type showed delayed septa enhancement on MR images. 15 cases on CT were misdiagnosed and Four cases on MRI were misdiagnosed and the accuracy of CT and MRI were 48.3% and 86.2% respectively.

Conclusions: In conclusion, CT and MRI are useful tools for SNN diagnosis.

Keywords

Liver Neoplasms Tomography, X-Ray Computed Magnetic Resonance Imaging

© 2012, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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