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Liver Lesions in Congestive Hepatopathy

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Evaluation and Management of Liver Masses

Abstract

Chronic congestive hepatopathy predisposes to the development of benign regenerative nodules or focal nodular hyperplasia (FNH) and malignant hepatocellular carcinoma (HCC). However, characteristic parenchymal abnormalities within the congested liver at computed tomography (CT) and magnetic resonance imaging (MRI) may result in an abnormal appearance of benign regenerative nodules or FNH. The American College of Radiology Liver Imaging Reporting and Data System criteria therefore no longer consider traditional enhancement characteristics applicable in patients with cardiac congestion and hepatic vascular disease. Imaging findings concerning for HCC in the congested liver include a heterogeneous or mosaic appearance of a mass, necrosis, internal lipid content, rapid growth, and venous tumor thrombus. Further evaluation of nodules with a hepatobiliary contrast agent or imaging follow-up is recommended to detect nodules with malignant potential in patients with congestive hepatopathy.

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Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Moira B. Hilscher & Patrick S. Kamath

  2. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Michael L. Wells

Authors
  1. Moira B. Hilscher
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  2. Michael L. Wells
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  3. Patrick S. Kamath
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Corresponding author

Correspondence to Michael L. Wells .

Editor information

Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Lewis R. Roberts

  2. Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Ju Dong Yang

  3. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Sudhakar K. Venkatesh

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Hilscher, M.B., Wells, M.L., Kamath, P.S. (2020). Liver Lesions in Congestive Hepatopathy. In: Roberts, L., Yang, J., Venkatesh, S. (eds) Evaluation and Management of Liver Masses. Springer, Cham. https://doi.org/10.1007/978-3-030-46699-2_9

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  • DOI: https://doi.org/10.1007/978-3-030-46699-2_9

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  • Online ISBN: 978-3-030-46699-2

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