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Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience

World Journal of Hepatology 2018年第5期10卷 417-424页

作者： Dharma Budi Sunjaya Guilherme Piovezani Ramos Manuel Bonfim Braga Neto Ryan Lennon taofic mounajjed Vijay Shah Patrick Sequeira Kamath Douglas Alano Simonetto School of Graduate Medical Education Mayo Clinic Division of Biomedical Statistics and Informatics Mayo Clinic Laboratory Medicine and Pathology Mayo Clinic Gastroenterology and Hepatology Mayo Clinic

AIM To characterize isolated non-obstructive sinusoidal dilatation(SD) by identifying associated conditions, laboratory findings, and histological patterns. METHODS Retrospectively reviewed 491 patients with SD between 1995 and 2015. Patients with obstruction at the level of the small/large hepatic veins, portal veins, or right-sided heart failure were excluded along with history of cirrhosis, hepatic malignancy, liver transplant, or absence of electrocardiogram/cardiac echocardiogram. Liver histology was reviewed for extent of SD, fibrosis, red blood cell extravasation, nodular regenerative hyperplasia, hepaticpeliosis, and hepatocellular plate atrophy(HPA). RESULTS We identified 88 patients with non-obstructive SD. Inflammatory conditions(32%) were the most common cause. The most common pattern of liver abnormalities was cholestatic(76%). Majority(78%) had localized SD to Zone Ⅲ. Medication-related SD had higher proportion of portal hypertension(53%), ascites(58%), and median AST(113 U/L) and ALT(90 U/L) levels. Nineteen patients in our study died within one-year after diagnosis of SD, majority from complications related to underlying *** Significant proportion of SD and HPA exist without impaired hepatic venous outflow. Isolated SD on liver biopsy, in the absence of congestive hepatopathy, requires further evaluation and portal hypertension should be rule out.

关键词： Sinusoidal dilatation Sinusoidal obstruction syndrome Hepatic plate atrophy

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CT of hepatocellular carcinoma in non-alcoholic fatty liver disease: imaging characteristics and inter-rater agreement

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Hepatoma Research 2019年第10期5卷 42-52页

作者： Ishan Garg Scott M.Thompson Shannon P.Sheedy taofic mounajjed Ashish Khandelwal Eric C.Ehman Candice A.Bookwalter Sudhakar K.Venkatesh Department of Radiology Mayo Clinic College of MedicineRochesterMN 55905USA Department of Laboratory Medicine and Pathology Mayo Clinic College of MedicineRochesterMN 55905USA

Aim:To determine the computed tomography(CT)features of non-alcoholic fatty liver disease(NAFLD)associated hepatocellular carcinoma(HCC).Methods:In this institutional review board approved study,we reviewed 38 patients with NAFLD(68.4%male;mean age 63 years)with histology confirmed HCC and triphasic liver *** images were independently reviewed by four readers blinded to clinical and pathology *** reviewers assessed HCC for arterial phase hyper enhancement(APHE),portal venous phase washout(PVWO),delayed phase washout(DPWO),and enhancing *** of cirrhotic morphology and portal hypertension(PH)were also *** final CT features were determined by majority and a fifth reader reviewed cases lacking ***-rater agreement was determined by prevalence-adjusted ***:Mean HCC size was 3.6±2.8 cm(range,1.1-16.0 cm).The HCCs showed APHE in 92.1%,PVWO in 55.3%,DPWO in 81.6%,and enhancing capsule in 44.7%.Cirrhotic morphology was present in 65.8%and PH in 63.2%.Inter-rater agreement was moderate to almost perfect for APHE(0.74-1.0),cirrhosis(0.79-0.89),and PH(0.79-0.95),weak to perfect for DPWO(0.47-0.95)and poor for PVWO(0-0.42). ;Conclusion:NAFLD associated HCC demonstrate less frequent portal venous washout on CT which may affect their imaging diagnosis.

关键词： Hepatocellular carcinoma computed tomography fatty liver inter-rater agreement non-alcoholic fatty liver disease

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