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Radiological-pathological correlation of mass lesions in the liver.
1Department of Radiology & Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories.
Australasian Radiology
|August 1, 1991
Summary
Radiographs of barium-injected human livers reveal distinct arteriographic patterns for various lesions. These findings aid in differentiating liver cysts, haemangiomas, focal nodular hyperplasia, metastases, and hepatocellular carcinoma on sonography.
Area of Science:
- Radiology
- Pathology
- Gastroenterology
Background:
- Accurate differentiation of liver lesions is crucial for effective patient management.
- Arteriography provides detailed vascular information, but its application in post-mortem liver tissue requires specialized techniques.
- Understanding the vascular patterns of different liver pathologies is key to interpreting imaging findings.
Purpose of the Study:
- To correlate high-definition arteriographic findings with macroscopic and microscopic pathology in human liver lesions.
- To identify characteristic arteriographic features that can help distinguish between various space-occupying liver lesions.
Main Methods:
- Thirty-two human livers were autopsied, including seven with various lesions.
- Fine particle barium was injected into the arterial system (and portal system in one case) of liver slices.
- High-definition radiographs were obtained and correlated with macroscopic and microscopic pathological examination.
Main Results:
- Liver cysts compressed arteries; a spurious halo seen on whole liver radiographs was disproven on detailed films.
- Haemangiomas showed a small vessel pattern, explaining hyperechoic sonograms, with potential for hypoechoic areas due to involution or hemorrhage.
- Focal nodular hyperplasia lesions had poor arterial supply but filled via portal injection.
- Metastases displayed peripheral small vessels, central necrosis, and normal-sized peripheral arteries without a large feeding artery.
- Hepatocellular carcinoma demonstrated a large feeding artery and significantly higher vascularity compared to metastases.
Conclusions:
- Distinct arteriographic features of liver lesions were identified using high-definition radiography of injected autopsy specimens.
- These arteriographic characteristics correlate with pathological findings and can aid in differentiating liver lesions, particularly on sonography.
- The study highlights the value of detailed vascular imaging in understanding and diagnosing liver pathologies.