Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

458 results found
Article

Hepatic attenuation on CT

Hepatic attenuation on CT, reflected by Hounsfield values, depends on a combination of factors including the presence or absence, as well as the phase, of IV contrast administration. Allowing for all these factors, the mean unenhanced attenuation value is around 55 HU 4. Pathology Several int...
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Hepatic capsular retraction

Hepatic capsular retraction is an uncommon finding related to several benign and malignant pathologies and also intrinsic or extrinsic causes; a list of differential diagnoses is given below: malignant tumour (primary or metastatic) - especially cholangiocarcinoma but hepatocellular carcinoma i...
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Hepatic capsular retraction (mnemonic)

The following mnemonics can be used as reminders of the causes of hepatic capsular retraction: CT CHIEF FILTH E Mnemonics CT CHIEF C: cholangiocarcinoma (intrahepatic) T: treated hepatic metastasis or hepatocellular carcinoma C: cirrhosis with confluent hepatic fibrosis H: haemangioma (e...
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Hepatic carcinoid

Primary hepatic carcinoid is an extremely rare type of carcinoid tumor, with somewhere between 60-90 cases reported in the literature. Metastatic carcinoid tumor from the gastrointestinal tract to the liver is far more common. Clinical presentation Some patients present with carcinoid syndrome...
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Hepatic carcinosarcoma

Hepatic carcinosarcoma is a very rare tumour that is defined by mixed histological features.  Terminology This tumour has also been referred to as malignant mixed tumour, spindle cell carcinoma, pseudosarcoma or sarcomatoid carcinoma 1,2.  Pathology Hepatic carcinocarcinoma contain a mixture...
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Hepatic epithelioid hemangioendothelioma

Hepatic epithelioid haemangioendothelioma (HEHE) is a rare, low to intermediate grade malignant hepatic vascular tumour. Epidemiology There may be a greater female incidence (with reported male-to-female ratio, 3:2), with peak incidence thought to be around 30-40 year-old. Pathology Histolog...
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Hepatic haemangioma

Hepatic haemangiomas, also known as hepatic venous malformations, are benign non-neoplastic hypervascular liver lesions. They are frequently diagnosed as an incidental finding on imaging, and most patients are asymptomatic. From a radiologic perspective, it is important to differentiate haemangi...
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Hepatic haemangiomatosis

Hepatic haemangiomatosis is a situation when the are multiple haemangiomas affecting the liver. When the lesions are spread throughout the liver, then this is termed diffuse hepatic haemangiomatosis (the latter situation typically occurs in infants 1). In CT imaging, the presence of phleboliths...
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Hepatic haemosiderosis

Hepatic haemosiderosis refers to the deposition of haemosiderin in the liver. Pathology Hepatic iron overload can be in the form of 7 diffuse heterogeneous segmental focal hypersiderosis intralesional siderosis periportal siderosis. In the absence of genetic haemochromatosis and system...
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Hepatic hydrothorax

Hepatic hydrothorax (HH) is an uncommon manifestation of cirrhosis with ascites. It is one of the pulmonary complications of cirrhosis with portal hypertension.  It is characterised by formation of pleural effusions usually greater than 500 mL, in patients with portal hypertension without any o...
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Hepatic infarction

Hepartic infarction is an extremely rare situation because of the liver's dual blood supply by the hepatic artery and portal vein. Hepatic infarction can occur when there is both hepatic arterial and portal vein flow compromise but most cases are due to acute portal venous flow compromise 11. E...
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Hepatic inflammatory pseudotumour

Hepatic inflammatory pseudotumours (IPT) are rare benign hepatic lesions. Epidemiology Most common in young adults with males affected more than females 7.  Pathology Aetiology is unknown 7.  Macroscopic appearance Hepatic IPT is often seen as a well-circumscribed, encapsulated inflammator...
Article

Hepatic leiomyosarcoma

Hepatic leiomyosarcomas are rare primary malignant tumors derived from smooth muscle cells in the liver. Epidemiology Hepatic leiomyosarcoma is rare 1. An equal sex distribution and a broad age range (5 months-66Y) has been reported. Some have suggested an associated with AIDS 2. Pathology T...
Article

Hepatic lipoma

A hepatic lipoma is a rare, usually asymptomatic, benign lesion of the liver. Pathology They may be composed purely of fat cells, or they may be mixed with adenomatous, angiomatous or myomatous tissue, resulting in lesions such as adenolipoma, angiomyolipoma or myelolipoma5. Associations tub...
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Hepatic lymphangioma

A hepatic lymphangioma is a rare benign condition that corresponds to focally dilated lymphatic channels in the liver.  Clinical presentation Most cases are asymptomatic. Pathology A lymphangioma is a benign lesion that can occur at almost any location in the body. Hepatic involvement is les...
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Hepatic lymphoma

Hepatic lymphoma is a rather broad term given to any form of hepatic involvement with lymphoma. This can be broadly divided into: secondary hepatic involvement with lymphoma: most common by far, many tend to be non-Hodgkin lymphoma (NHL) 1 primary hepatic lymphoma: extremely rare Pathology R...
Article

Hepatic mesenchymal hamartoma

Hepatic mesenchymal hamartoma is an uncommon benign hepatic tumour. Some authors even consider this to be a developmental anomaly rather than a cystic neoplasm 9,12. Epidemiology It typically occurs in children and neonates, with most cases presenting within the first two years of life 3. Ther...
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Hepatic metastases

Hepatic metastases are 18-40 times more common than primary liver tumours 6. Ultrasound, CT, and MRI are all useful for detection of hepatic metastases and evaluation across multiple postcontrast CT series, or MRI pulse sequences are necessary. The most common sites of primary malignancy that me...
Article

Hepatic myeloid sarcoma

Hepatic myeloid sarcoma is a collection of immature myeloid cells than can present as a mass (or as masses) in the liver. It is a rare complication of haematologic disease. Terminology Hepatic myeloid sarcoma is also referred to as "granulocytic sarcoma" or "chloroma". Epidemiology Myeloid s...
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Hepatic osteodystrophy

Hepatic osteodystrophy is an often forgotten metabolic bone disease seen in patients with chronic liver disease, in particular cirrhosis, primary biliary cirrhosis, and primary sclerosing cholangitis. These patients have increased risk factors for developing osteoporosis such as hypogonadism, al...
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Hepatic peliosis

Hepatic peliosis is a rare benign vascular condition characterised by dilatation of sinusoidal blood filled spaces within the liver.  There may be involvement of other organs, most commonly the spleen and bone marrow.  It can be seen in a variety of settings and is important as appearances may m...
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Hepatic pseudolesion near falciform ligament

Hepatic pseudolesions near the falciform ligament show abnormal attenuation without mass effect. They may be seen on contrast enhanced CT scans as either a region of high or low attenuation relative to the rest of the liver. They are typically located in the medial segment of the left lobe of th...
Article

Hepatic siderotic nodules

Hepatic siderotic nodules are a type of regenerative nodule formed in a cirrhotic liver. They occur in hepatic haemosiderosis. The nodules have an increased iron content compared with other regenerative nodules. They may be nondysplastic or dysplastic. Pathology The reason why these nodules co...
Article

Hepatic solitary fibrous tumour

Hepatic solitary fibrous tumours (hepatic SFTs) are rare mesenchymal tumours. Epidemiology Fewer than 60 cases have been reported in the literature. Female predominance (~70%). There is a mean age of 52 years at presentation, but a wide range of incidence (16-84 years). Clinical presentation ...
Article

Hepatic steatosis

Hepatic steatosis refers to an increase of intracellular fat in the liver. It is widely mischaracterised by both radiologists and sonographers that it represents 'fatty infiltration' however the fat is in the hepatocytes and not the extracellular matrix. On imaging grounds, it can broadly be div...
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Hepatic veins

The hepatic veins are three large veins which drain the hepatic parenchyma into the inferior vena cava (IVC), named the right hepatic vein, middle hepatic vein and left hepatic vein. The veins are important landmarks, running in between and hence defining the segments of the liver. There are sep...
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Hepatic veno-occlusive disease

Hepatic veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a condition arising from occlusion of hepatic venules. Clinical presentation right upper quadrant pain painful hepatomegaly ascites abnormal liver function tests Pathology Toxic injury to liver s...
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Hepatisation of the gallbladder

Hepatisation of the gallbladder is a sonographic entity in which the gallbladder lumen is entirely filled with tumefactive sludge giving the gallbladder a similar appearance to liver parenchyma. It is one of the causes of non-visualisation of the gallbladder on sonography. Pathology In the set...
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Hepatitis B virus

Hepatitis B virus (HBV) is a circular DNA virus endemic in many parts of the world. It is a risk factor for the development of hepatocellular carcinoma (HCC). Clinical presentation Acute HBV infection is most often subclinical and asymptomatic. Symptomatic patients (~33%) may experience fever,...
Article

Hepatitis C virus

Hepatitis C virus (HCV) is an RNA virus and a member of the Flaviviridae family. It is a risk factor for the development of hepatocellular carcinoma (HCC). Pathology Route of transmission The most common route of transmission is through blood products and contaminated needles. Unprotected sex...
Article

Hepatobiliary contrast agents and LI-RADS

LI-RADS (Liver Imaging Reporting and Data System) is both a set of standardised terminology and a classification system for imaging findings in liver lesions. The LI-RADS score for a liver lesion is an indication of its relative risk for hepatocellular carcinoma (HCC). The classification system ...
Article

Hepatobiliary imaging in nuclear medicine

Hepatobiliary imaging in nuclear medicine can be accomplished with multiple different radiotracers. The choice of tracer depends on the clinical question. Common tracers include Tc99m-IDA (iminodiacetic acid) analogues: most commonly used tracer; used for evaluation of the biliary system (e.g....
Article

Hepatobiliary MRI contrast agents

Hepatobiliary MRI contrast agents are specialised agents used to aid diagnosis in MRI. They are separated into three categories: gadolinium-based agents, manganese-based agents and superparamagnetic iron oxide particles.  Gadolinium based agents Gadolinium (Gd) based contrast agents are class...
Article

Hepatobiliary system

The hepatobiliary system consists of the: liver biliary tree (both intra- and extra-hepatic) gallbladder The pancreas is included by some. 
Article

Hepatoblastoma

Hepatoblastoma is the most common primary malignant liver tumour in children under four years of age who usually present with painless abdominal mass and raised AFP. It is tumour of embryonic origin. Epidemiology Most cases are seen during the first 18 months of life and diagnosis in adulthood...
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Hepatoblastoma (staging)

As expected there are a number of different staging systems for hepatoblastoma. PRETEXT grouping system of paediatric liver tumours not specific to hepatoblastoma; used in all paediatric liver tumours Intergroup staging system specific for hepatoblastoma (see below) Intergroup sta...
Article

Hepatoblastoma histological classification

Although hepatoblastomas can be histologically classified into a variety of sub types, it is important to remember that with the possible exception of small cell undifferentiated sub type, prognosis is independent of histology when adjusted for stage gender and age 1. major categories epitheli...
Article

Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. It is strongly associated with cirrhosis, from both alcohol and viral etiologies. HCC constitutes approximately 5% of all cancers partly due to the high endemic rates of hepatitis B infection 1. Epidemiology HCC...
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Hepatocellular carcinoma (staging)

Hepatocellular carcinoma staging classifications supersede the typical TNM staging system seen in most other epithelial cancers, as the TNM staging system has been found to not be as prognostically useful for stratification of patients with hepatocellular carcinoma. Several substitute staging sy...
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Hepatocellular carcinoma (surveillance)

Hepatocellular carcinoma surveillance programs have been adopted by some health systems in attempts to effect an early diagnosis of hepatocellular carcinoma in high-risk populations.  Rationale The idea behind hepatocellular carcinoma screening, as with any screening program, is to detect clin...
Article

Hepatoduodenal ligament

Hepatoduodenal ligament is the peritoneal ligament of lesser omentum, which attaches the duodenum to the liver. Hepatoduodenal ligament contains: portal vein hepatic artery  common hepatic duct  part of cystic duct Hepatoduodenal ligament is a rout of spread of diseases of pancratic head t...
Article

Hepatofugal

Hepatofugal or non-forward portal flow (NFPF) is an abnormal flow pattern where the portal venous flow is from the periphery of the liver towards the porta and backwards along the portal vein. This phenomenon is not uncommon in patients with liver disease 3. It is the opposite of hepatopetal. ...
Article

Hepatolithiasis

Hepatolithiasis is the presence of bile duct stones within the intrahepatic bile ducts, specifically before the confluence of the right and left hepatic ducts.  Epidemiology Hepatolithiasis is common Asia and the Pacific, with a prevalence of ~40%. It is rare in the West with a prevalence of ~...
Article

Hepatomegaly

Hepatomegaly refers to an increase in size or enlargement of the liver.  Pathology Aetiology Hepatomegaly can result from a vast range of pathology including, but not limited to, the following: malignancy/cellular infiltrate multiple metastases lymphoma(s) leukaemia(s) hepatocellular car...
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Hepatopetal

Hepatopetal denotes flow of blood towards the liver, which is the normal direction of blood flow through the portal vein. The term is typically used when discussing the portal vein or recanalised vein of the ligamentum teres in patients with suspected portal hypertension. It is the opposite of ...
Article

Hepatopulmonary syndrome

Hepatopulmonary syndrome (HPS) refers to the combination of hepatic dysfunction (cirrhosis) hypoxaemia (alveolar-arterial O2 gradient of >15mmHg; >20mmHg in >64year old patients). peripheral pulmonary arterial dilatation (due to right to left micro-shunts). Epidemiology It is estimated to b...
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Hereditary haemorrhagic telangiectasia

Hereditary haemorrhagic telangiectasia (HHT) is also known as Osler-Weber-Rendu syndrome. Epidemiology Worldwide prevalence ~1.5 per 100,000. Wide geographic variability with much higher incidence in certain regions, e.g. 1 in 200 in Dutch Antilles, 1 in 3500 in France. Clinical presentation ...
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HNF 1 alpha mutated hepatic adenoma

HNF 1 alpha mutated hepatic adenomas are a genetic and pathologic subtype of hepatic adenoma. Their appearance and prognosis is different than other subtypes. Epidemiology They are the second most common (30-35%) hepatic adenoma, after the inflammatory subtype. They occur only in female patien...
Article

Hutson loop

A Hutson loop is type of biliary bypass procedure, It is a form of Roux-en-Y choledo chojejunostomy that is fixed to the abdominal wall. It is usually performed to facilitate subsequent retrograde extraction of residual or recurrent calculi.
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Hyalinised hepatic haemangioma

A hyalinised hepatic haemangioma (or sclerosing/sclerosed hepatic haemangioma) is a rare variant of hepatic haemangioma. Because of its unusual imaging features, it cannot be reliably differentiated from a malignant tumour without biopsy. Pathology A hyalinised haemangioma differs from a typic...
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Hyperattenuating gallbladder (differential)

A hyperattenuating gallbladder may occur from a number of different aetiologies: sludge in the gallbladder vicarious excretion of intravenous contrast (iodinated contrast or gadolinium contrast) hyperconcentrated bile noncalcified gallstones haemorrhage Radiographic features gallbladder m...
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Hyperechoic liver lesions

A hyperechoic liver lesion on ultrasound can arise from a number of entities, both benign and malignant. A benign hepatic haemangioma is the most common entity encountered, but in patients with atypical findings or a risk for malignancy, other entities must be considered. Benign hepatic haeman...
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Hypertrophy of the caudate lobe

Hypertrophy of the caudate lobe is seen in a number of conditions, including: cirrhosis : most common Budd-Chiari syndrome primary sclerosing cholangitis (PSC) (end stage) congenital hepatic fibrosis cavernous transformation of the portal vein
Article

Hypervascular liver lesions

Hypervascular liver lesions may be caused by primary liver pathology or metastatic disease. Differential diagnosis Primary lesions hepatocellular carcinoma (HCC) most common hypervascular primary liver malignancy early arterial phase enhancement and then rapid wash out rim enhancement of c...
Article

IgG4-related disease

IgG4-related disease (IgG4-RD) is a systemic disease that is characterised by extensive IgG4-positive plasma cells and T-lymphocyte infiltration of various organs. Terminology This condition has been known by many other names in the past, such as IgG4-related sclerosing disease, IgG4-related s...
Article

Imaging in liver transplantation

Imaging in liver transplantation is aimed to evaluate donor and recipient for successful transplantation and its outcome. Pre-transplant evaluation Donor volume of liver parenchymal disease (diffuse or focal) vascular anatomy arterial variations venous variations biliary anatomy Recipie...
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In-phase and out-of-phase sequences

In-phase (IP) and out-of-phase (OOP) sequences correspond to paired MRI gradient echo (GRE) sequences obtained with the same repetition time (TR) but with two different echo time (TE) values.  Applications The main application of the IP-OOP sequences is to identify pathological (microsopic) fa...
Article

Increased splenic density

Increased splenic density can be due to a number of processes. The density may be due to calcification (most common) or other compounds (iron, Thorotrast), and can be seen (often incidentally) on abdominal radiographs and CT. On CT the usual splenic attenuation is 35-55 HU or ~10 HU 6 lower than...
Article

Infantile hepatic haemangioma

Infantile hepatic haemangiomas (IHH) are a liver lesion composed of large endothelial-lined vascular channels seen in fetuses and neonates. It should not be confused with a hepatic epithelioid haemangioendothelioma, which occurs in older patients. Terminology Those benign tumours were previous...
Article

Inferior pancreaticoduodenal artery

The inferior pancreaticoduodenal artery is the first branch of the superior mesenteric artery (SMA), though it often arises from the first jejunal branch. It anastomoses with branches of the superior pancreaticoduodenal artery (from the gastroduodenal artery) and it supplies the head of the pan...
Article

Inferior vena cava web

Inferior vena cava (IVC) webs are an uncommon condition characterised by obstruction of the hepatic segment of the inferior vena cava by a membrane or fibrous band. This is often associated with occlusion of one or more of the hepatic veins. Clinical presentation If there is hepatic vein invol...
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Infiltrative hepatocellular carcinoma

Infiltrative hepatocellular carcinoma (also known as diffuse hepatocellular carcinoma (HCC)) is an infrequent subtype of HCC, which has particular imaging characteristics. Because of these characteristics, it has been called cirrhotomimetic-HCC or cirrhosis-like HCC. Epidemiology Infiltrative ...
Article

Inflammatory hepatic adenoma

Inflammatory hepatic adenomas are a genetic and pathological subtype of hepatic adenoma. Their appearance and prognosis is different than other subtypes and has highest incidence of haemorrhage amongst hepatic adenoma subtypes. Epidemiology Most common subtype of hepatic adenoma (40-50%). Occu...
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Inflammatory myofibroblastic tumour

Inflammatory myofibroblastic tumours (IMT), also known as plasma cell granulomas, are rare neoplasms that have a diverse spectrum of biological behaviour.  Epidemiology It can occur at any age and there is currently no recognised gender predilection. Pathology Composed of spindle cells (key ...
Article

Inflammatory polyps of the gallbladder

Inflammatory polyps of the gallbladder are a subtype of gallbladder polyps, representing ~10% of polyps. Pathology Thought to develop from chronic inflammation, with deposition of cholesterol in the gallbladder wall and mucosal irritation, leading to a fibrous reaction 2. There is no evidence...
Article

Insulinoma

Insulinomas are the most common sporadic endocrine tumour of the pancreas. Epidemiology Account for 40% of syndromic pancreatic endocrine tumours. Overall incidence of ~0.0003%. Clinical presentation Typically insulinomas present with Whipple's triad consisting of: fasting hypoglycemia (<50...
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Interstitial oedematous pancreatitis

Interstitial oedematous pancreatitis is one of the two subtypes of acute pancreatitis. It is normally referred to as "acute pancreatitis" or "uncomplicated pancreatitis" in day-to-day use. Please refer to the article on acute pancreatitis for further details. 
Article

Intrabiliary rupture of hepatic hydatid cyst

Intrabiliary rupture of hepatic hydatid cyst is a common complication associated with hepatic hydatid cysts. It is important to appreciate the direct and indirect signs of this condition. Radiographic features The radiological features of intrabiliary rupture of a hepatic hydatid cyst can be c...
Article

Intraductal papillary mucinous neoplasm

Intraductal papillary mucinous neoplasms or tumours (IPMNs or IMPTs) are cystic tumours of the pancreas. Epidemiology These tumours are most frequently identified in older patients (50-60 years of age) 6. Main duct type (see below) appears to present a decade or so earlier on average than bran...
Article

Intrahepatic arterioportal shunt

Intrahepatic arterioportal shunts represent abnormal flow between the portal venous system and a hepatic arterial system within the liver. They can be a reversible cause of portal hypertension. Clinical presentation Clinical features will depend on size and other underlying pathology. Small sh...
Article

Irreversible electroporation

Irreversible electroporation (IRE), also known as non-thermal irreversible electroporation (NTIRE), is a non-invasive soft-tissue ablation technique used for tumour ablation in regions that require very high precision and preservation of surrounding structures. Mechanism In IRE electrodes are ...
Article

Jaundice

Jaundice refers to a clinical sign of hyperbilirubinemia (>2.5 mg/dl) which has many causes. It is often a clue to a diagnosis. It can be largely divided into two types: non-obstructive, i.e. pre-hepatic and hepatic causes obstructive, i.e. post-hepatic causes Imaging has a major role in dete...
Article

Kasai classification

Kasai classification is used to describe the three main anatomical types of biliary atresia. Classification type I: obliteration of common bile duct (patent cystic and common hepatic duct) type II IIa: obliteration of common hepatic duct (patent cystic and common bile duct), sometimes with a...
Article

Klatskin tumour

Klatskin tumour is a term that was traditionally given to a hilar cholangiocarcinoma, occuring at the bifurcation of the common hepatic duct. Typically, these tumours are small, poorly differentiated, exhibit aggressive biologic behaviour, and tend to obstruct the intrahepatic bile ducts. Epide...
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Komi classification of bile duct cysts

Komi classification of bile duct cysts, as stated by Komi et al, divides anomalous union of the pancreatico-bile ducts (AUPBD) into 3 types based on the angle of union of the ducts 1. Classification type I: union of the ducts at a right angle to each other type Ia: without dilatation or  typ...
Article

Kyste hydatique

This originally French article needs further translation and merging with the existing English article on hydatid disease. Le kyste hydatique est une affection parasitaire due au taenia granulosis, considérée comme une zoonose atteignant aussi bien l'homme que les animaux, notamment les carnivo...
Article

Left hepatic artery

The left hepatic artery (LHA) is formed when the proper hepatic artery (PHA) bifurcates. The hepatic arteries provide 25% of the blood supply and 50% of the oxygen supply to the liver. Gross anatomy The PHA bifurcates into the left and right hepatic arteries on reaching the porta hepatis. Thes...
Article

Left triangular ligament of the liver

The left triangular ligament is a peritoneal suspensory ligament of the liver. It is formed by the fusion of the superior and inferior reflections of the coronary ligament. It is shorter than the right triangular ligament and does not separate the left subphrenic space from the subhepatic space.
Article

Lemmel syndrome

Lemmel syndrome is defined as an obstructive jaundice caused by a periampullary duodenal diverticulum (of the second part of the duodenum) compressing the intrapancreatic part of the common bile duct with resultant upstream dilatation of the extra- and intrahepatic bile ducts. Clinical presenta...
Article

Leptospirosis

Leptospirosis results from infection of the zoonoses Leptospira sp. The condition can have multi-organ manifestations. Commonly affected organs include: lung: pulmonary leptospirosis liver: hepatic leptospirosis central nervous system: CNS leptospirosis skeletal muscle: muscular leptospirosi...
Article

Leukaemic infiltration of liver

Leukaemic infiltration of the liver can occur with several forms of leukaemia inclusive of acute myeloid leukaemia (AML), acute lymphoid leukaemia (ALL) and chronic myeloid leukaemia (CML).  Radiographic features CT Described features are non-specific but include: hepatomegaly periportal lo...
Article

LI-RADS

LI-RADS (Liver Imaging Reporting and Data System) is both a set of standardised terminology and a classification system for imaging findings in liver lesions. The LI-RADS score for a liver lesion is an indication of its relative risk for hepatocellular carcinoma (HCC). The classification system ...
Article

Light bulb sign (hepatic haemangioma)

The light bulb sign of a hepatic haemangioma is a feature than can be seen on MRI imaging with a classic hepatic haemangioma. This refers to marked hyperintensity seen on heavily T2 weighted sequences that has been likened to a glowing light bulb. See also light bulb sign - shoulder light bul...
Article

Limy bile

Limy bile stands for the presence of a viscous substance in the dependent parts of the gallbladder and/or bile ducts, almost entirely composed of calcium carbonate, and therefore highly radiopaque. Terminology The terms limy bile and calcium milk gallbladder can be used interchangeably for inc...
Article

Littoral cell angioma of the spleen

Littoral cell angioma of the spleen (LCA) is a rare and relatively recently (1991) described vascular tumour of the spleen. Epidemiology Littoral cell angiomas may occur at any age and have no gender predilection. Clinical presentation Typically, patients with littoral cell angioma are found...
Article

Liver

The liver is the largest abdominal organ that plays a major role in metabolism and has a number of functions, including glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification. It is one of very few organs that has the ability to regen...
Article

Liver and biliary interventional procedures

There is a wide range of liver and biliary interventional procedures, both diagnostic and therapeutic, most commonly using CT-guidance or ultrasound-guidance.   Percutaneous transhepatic biliary interventions percutaneous transhepatic cholangiography (PTC) percutaneous transhepatic biliary dr...
Article

Liver biopsy (transjugular)

Transjugular liver biopsy (TJLB) is an alternative to a percutaneous liver biopsy in patients with diffuse liver disease, coagulopathy and ascites. It is sometimes done in combination with a transjugular intrahepatic portosystemic shunt (TIPSS) or venography. Indications massive ascites coag...
Article

Liver cancer (BCLC staging)

Barcelona clinic liver cancer (BCLC) staging uses a set of criteria to guide management of patients with hepatocellular carcinoma (HCC). The classification takes the following variables into account 1,2: performance status Child-Pugh score tumour size multiple tumours vascular invasion no...
Article

Liver lesions

Liver lesions represent a heterogeneous group of pathology ranging from solitary benign lesions to multiple metastases from a variety of primary tumours. Liver lesions may be infiltrative or have mass effect, be solitary or multiple, benign or malignant. Assessment of liver lesions takes into ...
Article

Liver lesions (paediatric)

Paediatric liver lesions are a heterogeneous group that include infiltrative lesions and those that demonstrate mass effect. Moreover, they may be solitary or multiple, benign or malignant: benign liver tumours malignant liver tumours Epidemiology There are differing frequencies of both beni...
Article

Liver protocol (MRI)

Examination of the liver with MRI requires numerous sequences and imaging at multiple times after the administration of gadolinium. Many variations exist, but a typical protocol would include:  Pre-contrast T2 T2 fat sat T1 weighted gradient echo in and out of phase T1 2D or 3D gradient ech...
Article

Liver trauma

The liver is one of the most frequently damaged organs in blunt trauma, and liver trauma is associated with a significant mortality rate. Epidemiology In blunt abdominal trauma, the liver is injured ~5% (range 1-10%) of the time 1,3. Clinical presentation Patients can present with right uppe...

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