RSNA | Journals

Journal Highlights

The following are highlights from the current issues of RSNA's two peer-reviewed journals.

MR of Hepatocellular Carcinoma in Cirrhotic Liver

Images in 46-year-old man with hepatitis C-related cirrhosis.

(a) Arterial-dominant phase transverse T1-weighted 3D spoiled gradient-recalled acquisition in the steady state (SPGR) MR image (3.6/1.7, 12º flip angle) shows a 6 mm nonspecific hypervascular lesion (thin arrow). This patient has a dominant 5 cm hepatocellular carcinoma (HCC) (not shown). A small nodule in the anterior lateral segment of the left lobe (thick arrow) was found to be a cirrhotic nodule. (b) At explant evaluation, the tiny hypervascular lesion was found to be a hemangioma (arrow).

Diagnosis of hepatocellular carcinoma (HCC) is heavily dependent on imaging characteristics. With the incidence of HCC expected to increase in the next two decades, largely due to hepatitis C infection and secondary cirrhosis, there is an ever growing demand on radiologists to detect smaller tumors, when curative therapies are most effective.

In a review article in the May issue of Radiology(RSNA.org/radiology), Jonathon M. Willatt, M.D., and colleagues focus on MR imaging features of HCC in the cirrhotic liver, diagnostic dilemmas, staging and treatment options and imaging after treatment. Included in the review:

• Regenerative and dyplastic nodules

• Lesions mimicking HCC

• Imaging technique

• Transplant allocation criteria for patients with cirrhosis and HCC

• Small (<2 cm) arterially enhancing lesions

• Surgical resection, percutaneous ablative techniques and transarterial chemoembolization

"There is increasing recognition of the role of imaging, and MR imaging in particular, in the surveillance of the cirrhotic liver for nodules, in the diagnosis of HCC and in the monitoring of lesions following local and systemic treatments," Dr. Willatt and colleagues conclude.

To access this Radiologyarticle now, click here.

This Month in RadiologyRedesigned

This Month in Radiology, the section of Radiology that provides readers with summaries of highlighted articles, has a new style starting with this month's issue.

Focusing on the "news" angle of each study, the new format also includes images to illustrate the featured studies. The online version will provide links to the corresponding articles and images.

"We wanted to give readers a quick graphic overview of a number of the articles of particular interest in each issue," said Radiology Editor Herbert Y. Kressel, M.D., of Beth Israel Deaconess Medical Center and Harvard Medical School in Boston. "The new format should help our readers quickly survey the issue highlights and identify articles most relevant to their needs."

See the new This Month in Radiologyby going to RSNA.organd clicking Radiologyin the lefthand sidebar.

Imaging the Inferior Vena Cava: A Road Less Traveled

Retroaortic left renal vein causing hypertension and hematuria in a 45-year-old woman.

(a) Contrast-enhanced CT scan shows compression of the left renal vein as it courses posterior to the aorta (arrow) (“nutcracker phenomenon”), along with prominent periureteric collateral vessels (*). (b) Volume-rendered image (anterolateral view) shows the left renal vein
(arrows) coursing posterior to the aorta (A), with a prominent periureteric collateral vessel (arrowhead) draining into the portosplenic confluence. P = portal vein, S = splenic vein.

(RadioGraphics2008;28:669–689) © RSNA, 2008. All rights reserved. Printed with permission.

Imaging, including ultrasound, MR and CT, plays a crucial role in the diagnosis and management of diverse conditions affecting the inferior vena cava (IVC).

In an article in the May-June issue of RadioGraphics(RSNA.org/radiographics), Harsh Kandpal, M.D., of the All India Institute of Medical Sciences, and colleagues describe and illustrate the imaging appearance of congenital anomalies of the IVC:

• Left IVC

• Double IVC

• Retrocaval ureter

• Absence of infrarenal IVC

• Retroaortic and circumaortic left renal vein

• Interruption of the IVC with azygous or hemiazygous continuation

• Portocaval shunt

The authors also detail pathologic conditions of the IVC—including membranous obstruction of the intrahepatic IVC, bland thrombus and intracaval tumors and trauma—and pitfalls in imaging the IVC.

"Familiarity with the imaging features of the various congenital and pathologic entities that can affect the IVC is important for early diagnosis and management," Dr. Kandpal and colleagues write.

To access this RadioGraphicsarticle now, click here.