MRAD 4218- MODULE 3 HEPATIC+ NEOPLASIA

drains blood from the GI system removing both nutrients and toxins

portal vein

cause of portal vein hypertension

- hepatic pathologies that affect the structure and functioning of the liver

- often results in esophageal varies

what pathology often results in esophageal varies

portal vein hypertension

ascites

abnormal accumulation of fluid in the peritoneal cavity

- has direct links to cirrhosis and chronic hepatitis

- may also be found in those with hepatocellular carcinoma.

- occurring due to the deficiency in albumin synthesis by the liver.

classification of ascites

degenerative

function of albumin

binds water and other blood products together

- holds fluid the circulatory system so that it does not leak out of the blood or lymph vessels

symptom of ascites

abdominal distention

treatment for ascites

incurable except for a liver transplant

- reduce salt intake

- diuretics to decrease fluid retention

- bed rest

- drainage

cirrhosis

chronic degenerative disease of the liver both in function and structure

- development of chronic fibrotic changes

classification of cirrhosis

inflammatory and degenerative

why might gynecomastia occur in cirrhosis?

liver is unable to inactivate the small amount of estrogen produced by adrenal glands

imaging used to visualize cirrhosis

US can detect the earliest stages

- CT is best to assess the progressive stages

-

treatment for cirrhosis

-TIPS

- paracentesis

- dietary

hepatitis

inflammation of the liver

- The infection is a reaction to certain drugs and toxins acquired by the body

- 5 types

hepatitis A

inflammation of the liver caused by the hepatitis A virus (HAV), usually transmitted orally through fecal contamination of food or water

- MOST COMMON

- short lived and does not become chronic

-

most common inflammatory disease of the liver

hepatitis

hepatitis B

transmitted through blood and body fluids including sexual contact

- 90% recover

- 10% go on to develop chronic form (cirrhosis and or hepatocellular carcinoma)

hepatitis C

inflammation of the liver

- transmitted by exposure to infected blood; most commonly through IV drug use this strain is rarely contracted sexually

- 20% go on to develop cirrhosis and or hepatocellular carcinoma

principle reason for liver transplants

chronic hepatitis C

hepatitis D

Delta Hepatitis. Secondary infection caused by a mutated hepatitis virus. Only develops in patients with Hepatitis B

hepatitis E

A virus spread via fecal-oral transmission (contaminated water) however only found in developing countries

- self limiting. Once poor sanitation is fixed, the outbreak will be contained

symptoms of hepatitis

similar to those of most hepatobiliary pathologies

- jaundice, hepatomegaly, fever, vomitting

diagnosis of hepatitis

via blood tests

imaging for hepatitis

US will show hepatomegaly, gallbladder thickening and edema.

periportal edema

common in patients with hepatitis

when is MRI used for hepatitis

to rule out other pathologies

liver hemangiomas are second to _______ in terms of common benign neoplasia of the liver

liver cysts

liver hemangioma classification

congenital neoplasia which is benign in nature

where do hemangiomas usually occur

right lobe of liver

- usually in women

on a CT of the liver when is full peripheral enhancement of the lesion with filling in of the lesion seen?

portal venous phase

In liver hemangioma, the enhancement in _______________________ is most important for diagnosis.

the portal venous and delayed phases

most common primary liver cancer

Hepatocellular carcinoma

precursors to hepatocellular carcinomas

cirrhoris

fatty liver disease

hepatitis B

hepatitis C

hepatocellular carcinomas metastisize to:

lungs

adrenal glands

lymph nodes

bone

modality to view hepatocellular carcinomas

CT

In Hepatocellular Carcinoma, the enhancement in the ________________________ is most important for diagnosis.

arterial and portal venous phases

carcinomas are more common in:

males

hemangiomas are more common in:

females

Hep B can be a precursor

carcinoma

Imaging modalities which demonstrate carcinoma in the liver

CT, U/S Nuclear Medicine, Angiography

The most common type of neoplasia in the liver

metastatic tumors

Tumors of the liver

Massive, nodular or diffuse

how metastases travel to the liver

circulatory system

What type of jaundice is the result of extensive liver damage?

hepatic

What causes jaundice?

accumulation of bilirubin in the extracellular tissues in the body.

In addition to a gallstone blocking the bile duct, what other pathology may cause obstructive jaundice?

tumor

is jaundice a disease?

No, it is a sign of a hepatobiliary disease.

sign of hepatitis seen on a plain abdominal x-ray

displaced bowel loops

Due to the multiple types of Hepatitis ___, there is no vaccine available to prevent it.

C

Highly contagious and is spread by contact with an infected person, through ingestion of contaminated food or water and is excreted through feces

Hep A

hepatomegaly

enlargement of the liver

Transmitted in infected serum and blood products

hep B

Can only exist in the presence of Hepatitis B

Hep D

Accumulation of fluid within the peritoneum caused by hepatic lymph weeping from the portal capillaries due to portal system overload.

ascites

Fibrotic changes in the liver parenchyma.

cirrhosis

location of the pain associated with cholelithiasis

RUQ

means of performing modern cholecystectomy

Laprascopy

classification of cholelithiasis

inflammatory

cholecystectomy

surgical removal of the gallbladder

predisposing factors for cholelithiasis

female, obesity, high blood cholesterol and fertile

lithotripsy is more successful on these stones than on gallstones

renal stones

how to radiographically differentiate a renal calculus from a gallstone

oblique projection

name for high levels of cholesterol in the bloodstream

hypercholesteremia

common name for cholelithiasis

gallstones

appearance of stones with very little calcium content

radiolucent

What action should be considered when performing an abdomen series on a patient with Ascites?

Increase technical factors for penetration

Question 10 (1 point)

Saved

What is the most common cause of cholecystitis?

Cholelithiasis

ascites and cirrhosis

What 2 hepatobiliary pathologies are seen on this image?

mercedes sign

What radiographic sign is evident in this CT image of cholelithiasis?

Which type of Jaundice could occur in patients with a predisposition to cholelithiasis?

obstructive