Autor(es):
Rosado, E 
; Pereira, J ; Bouchaibi, S ; Bali, M
Data: 2014
Identificador Persistente: http://hdl.handle.net/10400.10/1169
Origem: Repositório do Hospital Prof. Doutor Fernando Fonseca
Assunto(s): Liver neoplasms; Liver diseases; Cysts; Computed tomography; Magnetic resonance imaging
Descrição
LEARNING OBJECTIVES: To present the CT and MRI features of the cystic liver lesions, with emphasis on the differential diagnosis.
BACKGROUND: Cystic liver lesions are a frequent finding in abdominal imaging and may represent a broad spectrum of entities, ranging from benign developmental cysts to malignant neoplasms. Radiological features of various cystic liver lesions frequently overlap. Therefore, it is necessary to integrate imaging with clinical and laboratorial findings. The most important clinical parameters include age, clinical history and symptoms. Still, a histologic diagnosis is often required. Fine needle aspiration biopsy under image guidance is the preferred diagnostic method. It can be performed percutaneously or endoscopically providing adequate tissue samples.
IMAGING FINDINGS: The appearance of the cystic lesion at CT and MRI, concerning the size, the thickness of the wall, the presence or absence of septa, calcifications or internal nodules and the enhancing patterns allows the classification of the lesion as probably benign or malignant and, in most cases, a specific diagnosis can be suggested. Liver lesions with typical imaging features include simple cysts, autosomal dominant polycystic liver disease, biliary hamartomas, Caroli disease, cavernous hemangiomas, peribiliary cysts in cirrhotic patients, biliary cystadenoma and cystadenocarcinoma, cystic subtypes of hepatocellular carcinoma, cystic metastasis, pyogenic and amebic abscesses, hydatid cysts, extra-hepatic pseudocyst and intrahepatic biloma and hematoma.
CONCLUSION: Cystic lesions of the liver are common findings. Imaging features together with clinical and laboratorial findings allow an accurate diagnosis and appropriate patient management. FNA is sometimes needed for definitive diagnosis.
