Liver Comp

3 diseases of the liver

• HCC (Hepatocellular Carcinoma)

• Cirrhosis

• Hemangioma

• Fatty Liver

• Hepatitis B/C

• Liver mass

what is cirrhosis of the liver and what causes it

Replacement of liver tissue by fibrosis, scar tissue caused by alcohol, Chronic Viral Hepatitis, Chronic Bile Duct Blockage, or fatty liver disease

what is iron overload/hemochromatosis

condition where the body absorbs and stores too much iron, potentially leading to organ damage, there are iron deposits in the liver and spleen

what do we need to run for hemochromatosis and what do you run if don’t have it

PDFF Axial (Dixon) or if don’t have, run an Ax T2*

when should PDFF be run

pre contrast at sites that have the lisence

if pt. is unable to hold their breath what are your options

Consider PACE T2 FS & Haste
turboflash for vibe/inand out or Radial Vibe
can call MD to replace the ax vibe post images with Ax GRASP with 20s inject delay

how do we inject for a care bolus and what protocol do we usually perform a care bolus for

when scanner is running on care bolus (sag plane), watch for filling of pulmonary artery, breathe the pt then press stop and continue when pulmonary artery is full of contrast
we do this for eovist livers
1 cc/s, eovist

if pt has ascites do we cover fluid on our scans

no
consider them on 1.5T

what types of contrast are used for the liver

weight based gadavist and eovist

when do we use eovist

when ordered/asked for by dr. or focal nodular hyperplasia, 10ml, or when liver donor

special considerations for liver donor

10mL eovist and must have MD check exam before releasing pt

what preparation do we give all elastography and liver donor pts.

fast for 4 hours to reduce bowel motion

what indications could warrant the need for PDFF imaging

Used for Iron Deposits or Hemochromatosis

what indications could warrant the need for elastography

liver stiffness, fatty liver (steatosis) or liver quantification
ordering doc must write elastography on rx, check with rad if confused

when would you run the MRE only protocol

when pt only has auth for an elastography but not an abdomen
only run COR HASTE, PDFF, and MRE sequences