Browsing by Author "Bali, M"
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- Cystic lesions of the liverPublication . Rosado, E; Pereira, J; Bouchaibi, S; Bali, MLEARNING OBJECTIVES: To present the CT and MRI features of the cystic liver lesions, with emphasis on the differential diagnosis. BACKGROUND: Cystic liver lesions are a frequent finding in abdominal imaging and may represent a broad spectrum of entities, ranging from benign developmental cysts to malignant neoplasms. Radiological features of various cystic liver lesions frequently overlap. Therefore, it is necessary to integrate imaging with clinical and laboratorial findings. The most important clinical parameters include age, clinical history and symptoms. Still, a histologic diagnosis is often required. Fine needle aspiration biopsy under image guidance is the preferred diagnostic method. It can be performed percutaneously or endoscopically providing adequate tissue samples. IMAGING FINDINGS: The appearance of the cystic lesion at CT and MRI, concerning the size, the thickness of the wall, the presence or absence of septa, calcifications or internal nodules and the enhancing patterns allows the classification of the lesion as probably benign or malignant and, in most cases, a specific diagnosis can be suggested. Liver lesions with typical imaging features include simple cysts, autosomal dominant polycystic liver disease, biliary hamartomas, Caroli disease, cavernous hemangiomas, peribiliary cysts in cirrhotic patients, biliary cystadenoma and cystadenocarcinoma, cystic subtypes of hepatocellular carcinoma, cystic metastasis, pyogenic and amebic abscesses, hydatid cysts, extra-hepatic pseudocyst and intrahepatic biloma and hematoma. CONCLUSION: Cystic lesions of the liver are common findings. Imaging features together with clinical and laboratorial findings allow an accurate diagnosis and appropriate patient management. FNA is sometimes needed for definitive diagnosis.
- Intraductal papillary mucinous tumour of the biliary tractPublication . Rosado, E; Pereira, J; Bali, M; Delhaye, M; Matos, C
- Pancreatic neuroendocrine tumors: correlation between histogram analysis of apparent diffusion coefficient maps and tumor gradePublication . Pereira, JA; Rosado, E; Bali, M; Metens, T; Chao, SLPurpose: To explore the role of histogram analysis of apparent diffusion coefficient (ADC) MRI maps based on entire tumor volume data in determining pancreatic neuroendocrine tumor (PNT) grade. Methods and Materials: Retrospective evaluation of 22 patients with PNTs included low-grade (G1; n = 15), intermediate-grade (G2; n = 4), and high-grade (G3; n = 3) tumors. Regions of interest containing the lesion were drawn on every section of the ADC map containing the tumor and summated to obtain histograms for entire tumor volume. Calculated histographic parameters included mean ADC (mADC), 5th percentile ADC, 10th percentile ADC, 25th percentile ADC, 50th per- centile ADC, 75th percentile ADC (ADC75), 90th percentile ADC (ADC90) and 95th percentile ADC (ADC95), skewness and kurtosis. Histogram parameters were correlated with tumor grade by repeated measures analysis of variance with Tukey–Kramer post hoc comparisons. Results: The mADC, ADC75, ADC90, and ADC95 were significantly higher in G1 tumors (1283 ± 267; 1404 ± 300; 1495 ± 318; 1562 ± 347 9 10 -6 mm 2 /s) compared to G2 (892 ± 390; 952 ± 381; 1036 ± 384; 1072 ± 374 9 10 -6 mm 2 /s) and to G3 tumors (733 ± 225; 864 ± 284; 1008 ± 288; 1152 ± 192 9 10 - 6 mm 2 /s) (p value <0.05). Skewness and kurtosis were significantly different between G1 (0.041 ± 0.466; 2.802 ± 0.679) and G3 (1.01 ± 1.140; 5.963 ± 4.008) tumors (p value <0.05). Tumor volume (mL) was significantly higher on G3 (55 ± 15.7) compared to G1(1.9 ± 2.7) and G2 (4.5 ± 3.6) tumors (p value <0.05). In this small sample size, we did not detect statistically significant parameters between G2 (n = 4) and G3 (n = 3) tumors. Conclusions: Histographic analysis of ADC maps on the basis of the entire tumor volume can be useful in differentiating histologic grades of PNTs.