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Leao Filho H, de Oliveira CV, Horvat N. Other types of diffuse liver disease: is there a way to do it? Abdom Radiol (NY) 2020; 45:3425-3443. [PMID: 32306241 DOI: 10.1007/s00261-020-02530-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There are a variety of less common diffuse liver diseases that can be asymptomatic or cause severe liver dysfunction. For the majority of them, the association of clinical, laboratory, and imaging findings are needed to narrow the differential diagnosis. In this article, we will review and describe the rarer diffuse liver diseases including drug-related liver disease, inflammatory and infectious diseases, and deposition disorders such as amyloidosis, glycogen storage disease, Wilson's disease, and alpha-1 antitrypsin deficiency. Abdominal radiologists should be familiar with the imaging features of different types of diffuse liver diseases to help the multidisciplinary team involved in the treatment of these patients. The data related to some of these conditions are scarce and sometimes experimental, but we want to demonstrate to the reader the value of imaging techniques in their analysis and introduce the potential of new imaging methods.
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Nair AV, Yadav MK, Unni MN, Simi CM, Biji KA, Manoj KS, Ali S, Nair AK. Hepatic Amyloidosis: Something That Can camouflage and Deceive our Perception! INDIAN JOURNAL OF MEDICAL AND PAEDIATRIC ONCOLOGY : OFFICIAL JOURNAL OF INDIAN SOCIETY OF MEDICAL & PAEDIATRIC ONCOLOGY 2017; 38:236-239. [PMID: 28900341 PMCID: PMC5582570 DOI: 10.4103/ijmpo.ijmpo_46_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Amyloidosis is a multi-systemic diffusely infiltrating disease due to extracellular deposition of protein-mucopolysaccharide complexes. The type of protein deposited determines the subgroup of amyloid. Hepatic amyloidosis is a rare infiltrating disease affecting the hepatic parenchyma. A wide range of clinical presentation and atypical imaging findings delay the diagnosis of amyloidosis, while tissue biopsy demonstrating amyloid deposits is vital for a definitive diagnosis.
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Affiliation(s)
- Anirudh V Nair
- Department of Radiodiagnosis and Interventional Radiology, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
| | - Manish Kumar Yadav
- Department of Radiodiagnosis and Interventional Radiology, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
| | - Madhavan N Unni
- Department of Radiodiagnosis and Interventional Radiology, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
| | - C M Simi
- Department of Pathology, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
| | - K A Biji
- Department of Pathology, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
| | - K S Manoj
- Department of Radiodiagnosis and Interventional Radiology, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
| | - Shabeer Ali
- Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
| | - Ajith K Nair
- Department of Gastroenterology, Kerala Institute of Medical Science and Research Centre, Trivandrum, Kerala, India
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Trifanov DS, Dhyani M, Bledsoe JR, Misdraji J, Bhan AK, Chung RT, Samir AE. Amyloidosis of the liver on shear wave elastography: case report and review of literature. ACTA ACUST UNITED AC 2016; 40:3078-83. [PMID: 26254907 DOI: 10.1007/s00261-015-0519-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Amyloidosis is extremely rare, with an estimated 2225 new US cases reported annually. Signs and symptoms of the disease are subtle and imaging findings are not pathognomonic. Currently, diagnosis requires biopsy to demonstrate the deposition of amyloid. Elastography is a new imaging modality that evaluates tissue elasticity. It has shown to have efficacy in characterizing thyroid nodules, detecting prostate cancer, and staging liver fibrosis. We present a case of hepatic amyloidosis in a 51-year-old male that demonstrates significantly increased stiffness with a median value of 99.1 kPa (range 25.7-188.9 kPa) on shear-wave elastography (SWE) imaging, which is significantly higher than the cut-off range reported for cirrhosis on SWE (10.4-11.5 kPa). This finding raises the possibility that elastographic imaging may be sensitive to tissue mechanical changes induced by amyloid deposition.
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Affiliation(s)
- Dmitry S Trifanov
- Department of Abdominal Imaging and Intervention, Massachusetts General Hospital [MGH], Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Manish Dhyani
- Department of Abdominal Imaging and Intervention, Massachusetts General Hospital [MGH], Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Jacob R Bledsoe
- Department of Pathology, Massachusetts General Hospital [MGH], Harvard Medical School, Boston, MA, 02114, USA
| | - Joseph Misdraji
- Department of Pathology, Massachusetts General Hospital [MGH], Harvard Medical School, Boston, MA, 02114, USA
| | - Atul K Bhan
- Department of Pathology, Massachusetts General Hospital [MGH], Harvard Medical School, Boston, MA, 02114, USA
| | - Raymond T Chung
- Department of Hepatology, Medicine, Massachusetts General Hospital [MGH], Harvard Medical School, Boston, MA, 02114, USA
| | - Anthony E Samir
- Department of Abdominal Imaging and Intervention, Massachusetts General Hospital [MGH], Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
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Jørgensen JT, Rief M, Brismar TB, Wagner M, Albiin N. A new manganese-based oral contrast agent (CMC-001) for liver MRI: pharmacological and pharmaceutical aspects. Acta Radiol 2012; 53:707-13. [PMID: 22821959 DOI: 10.1258/ar.2012.120034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Manganese is one of the most abundant metals on earth and is found as a component of more than 100 different minerals. Besides being an essential trace element in relation to the metabolic processes in the body, manganese is also a paramagnetic metal that possesses similar characteristics to gadolinium with regards to T1-weighted (T1-w) magnetic resonance imaging (MRI). Manganese, in the form of manganese (II) chloride tetrahydrate, is the active substance in a new targeted oral contrast agent, currently known as CMC-001, indicated for hepatobiliary MRI. Under physiological circumstances manganese is poorly absorbed from the intestine after oral intake, but by the use of specific absorption promoters, L-alanine and vitamin D(3), it is possible to obtain a sufficiently high concentration in the liver in order to achieve a significant signal enhancing effect. In the liver manganese is exposed to a very high first-pass effect, up to 98%, which prevents the metal from reaching the systemic circulation, thereby reducing the number of systemic side-effects. Manganese is one of the least toxic trace elements, and due to its favorable safety profile it may be an attractive alternative to gadolinium-based contrast agents for patients undergoing an MRI evaluation for liver metastases in the future. In this review the basic pharmacological and pharmaceutical aspects of this new targeted oral hepatobiliary specific contrast agent will be discussed.
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Affiliation(s)
| | - Matthias Rief
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Torkel B Brismar
- Department of Radiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Moritz Wagner
- Department of Radiology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Nils Albiin
- Department of Radiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Yellapu RK, Yellapu K, Gour C. Hepatic amyloidosis presenting as intrahepatic cholestasis and portal hypertension: Case series and review of literature. Arab J Gastroenterol 2010. [DOI: 10.1016/j.ajg.2010.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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