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Purpose: This study prospectively assessed the performance of liver stiffness measurements using point shear-wave elastography (p-SWE) in comparison with transient elastography (TE) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD). Methods: Fifty-six consecutive adult patients with a histological diagnosis of NAFLD prospectively underwent TE and p-SWE on the same day. The median of 10 measurements (SWE-10), the first five (SWE-5), and the first three (SWE-3) measurements were analyzed for p-SWE. Liver biopsy was considered as the reference standard for liver fibrosis grade. Receiver operating characteristic (ROC) curves and areas under the ROC curves (AUROCs) were calculated to assess the performance of TE and p-SWE for the diagnosis of significant (F2-F4) and advanced fibrosis (F3-F4). Results: Forty-six patients (27 men, 19 women; mean age, 54.7±9.1 years) had valid p-SWE and TE measurements. Twenty-seven patients (58.7%) had significant fibrosis and 18 (39.1%) had advanced fibrosis. For significant fibrosis, both SWE-10 (AUROC, 0.787; P=0.002) and SWE-5 (AUROC, 0.809; P=0.001) provided higher diagnostic performance than TE (AUROC, 0.719; P=0.016) and SWE-3 (AUROC, 0.714; P=0.021), albeit without statistical significance (P=0.301). For advanced fibrosis, SWE-5 showed higher diagnostic performance (AUROC, 0.809; P<0.001) than TE (AUROC, 0.799; P<0.001), SWE-10 (AUROC, 0.797; P<0.001), and SWE-3 (AUROC, 0.736; P=0.003), although the differences were not statistically significant (P=0.496). The optimal SWE-10 and SWE-5 cutoff values were =8.4 and =7.8 for significant fibrosis, and =9.1 and =8.8 for advanced fibrosis, respectively. Conclusion: TE and p-SWE showed similar performance for the diagnosis of significant and advanced fibrosis in NAFLD patients. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is frequently associated with macrovascular invasion of the portal vein or hepatic veins in advanced stages. The accurate diagnosis of macrovascular invasion and the differentiation from bland non-tumoral thrombus has significant clinical and management implications, since it narrows the therapeutic options and it represents a mandatory contraindication for liver resection or transplantation. The imaging diagnosis remains particularly challenging since the imaging features of HCC with macrovascular invasion may be subtle, especially in lesions showing infiltrative appearance. However, each radiologic imaging modality may provide findings suggesting the presence of tumor thrombus rather than bland thrombus. The purpose of this paper is to review the current guidelines and imaging appearance of HCC with macrovascular invasion. Knowledge of the most common imaging features of HCC with macrovascular invasion may improve the diagnostic confidence of tumor thrombus in clinical practice and help to guide patients' management. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to qualitatively and quantitatively compare the enhancement pattern of focal nodular hyperplasia after gadobenate dimeglumine and gadoxetate disodium injection in the same patient.Methods: 1.5 T magnetic resonance imaging (MRI) examinations of 16 patients with 21 focal nodular hyperplasias studied after the injection of both contrast media were evaluated. Both MRI studies were performed in all patients. A qualitative analysis was performed evaluating each lesion in all phases. For quantitative analysis we calculated signal intensity ratio, lesion-to-liver contrast ratio and liver parenchyma signal intensity gain on hepatobiliary phase. Statistical analysis was performed with the Wilcoxon sign-rank test for clustered paired data and the McNemar test for paired frequencies. A P value < 0.05 was considered statistically significant.Results: At qualitative analysis no statistically significant differences were evident during any of the contrast-enhanced phases. Signal intensity ratio (P = 0.048), lesion-to-liver contrast ratio (P = 0.032) and liver parenchyma signal intensity gain (P = 0.012) were significantly higher on hepatobiliary phase after gadoxetate disodium injection.Conclusion: There were no significant differences in the MRI findings of focal nodular hyperplasia after the injection of a weight-based dose of either gadobenate dimeglumine or gadoxetate disodium. [ABSTRACT FROM AUTHOR]