Hepatobiliary Flashcards
How does a hepatic hemangioma show up on imaging?
- Peripheral to central enhancement in the arterial phase with persistent contrast on venous phase
MRI: hypodense T1; hyperdense T2
How does FNH show up on imaging?
Rapid arterial enhancement with a central stellate scar
MRI: Hypodense w/central scar in T1, isointense w/hyperintense scar on T2
How does a hepatic adenoma show up on imaging?
Arterial enhancement w/washout on portal phase
MRI: Mildly hyperintense on T1 and T2
How does HCC show up on imaging?
Enhancement on arterial phase with washout on delayed
How does cholangiocarcinoma show up on imaging?
Minor peripheral enhancement with capsular retraction
How can you differentiate FNH from hepatic adenoma?
+ sulfur colloid: FNH
- sulfur colloid: adenoma
What is the surgical management of cholangiocarcinoma?
T1a: through lamina propria cholecystectomy alone is sufficient
T1b: invades muscular layer (cholecystectomy with hepatectomy IVb and V and portal lymphadenectomy
What variant of HCC in seen in young patients without cirrhosis
Fibrolamellar will show up as neurotensin positive
What is the T staging for cholangiocarcinoma?
T1a: lamina propria
T1b: Muscular layer
T2: perimuscular connective tissue
T3: Serosa
T4: portain vein or hepatic artery
What margins are needed for HCC?
1cm
What FLR is needed for cirrhotics vs non cirrhotic patient?
Cirrhotic: 40%
Non-cirrhotic: 25%
What is the most common benign hepatic tumor?
Hemangioma
Rupture is rare
