诊断和处理肝脏良性肿块的实用方法。

IF 5.6 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Hepatology Communications Pub Date : 2024-10-30 eCollection Date: 2024-11-01 DOI:10.1097/HC9.0000000000000560
Reshma Reguram, Aishwarya Ghonge, Justin Tse, Renumathy Dhanasekaran
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引用次数: 0

摘要

肝脏良性病变是肝脏成像中最常诊断出的异常之一。它们通常是在常规检查或因无关原因进行的造影检查中偶然发现的。这些病变可以是实性病变,如血管瘤、局灶性结节增生、肝腺瘤或囊性病变。磁共振成像技术的最新进展,尤其是肝细胞特异性造影剂的应用,增强了对这些病变的定性,减少了对侵入性组织取样的依赖。尽管如此,组织取样在评估不确定病变或具有恶性潜能的病变时仍起着至关重要的作用。虽然大多数肝脏良性病变没有症状,但有些病变会出现症状,引起不适、疼痛或出血,尤其是当病变较大时。深入了解病变的分子基础对制定患者管理策略至关重要,尤其是在区分需要手术干预的病变和可以监测的病变方面。例如,肝腺瘤的分子亚分类提供了机理方面的见解,并确定了某些恶性风险较高的亚型。大多数肝脏良性病变都可以安全地进行监测;但对于肝硬化或已知原发性恶性肿瘤的患者,则需要高度怀疑癌症。关键是要仔细评估在这些患者中发现的任何肝脏病变,以确保不忽视不确定的病变。肝脏良性病变的有效治疗涉及一个多学科团队,包括肝病专家、外科医生和放射科医生,以确保为患者提供全面和个性化的治疗。本综述概述了常见肝脏良性病变的临床表现,提供了诊断和管理框架。重点放在个性化方法上,通过利用先进的成像技术和多学科协作,最大限度地减少患者的痛苦并优化治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Practical approach to diagnose and manage benign liver masses.

Benign liver lesions are among the most commonly diagnosed abnormalities in liver imaging. They are often discovered incidentally during routine examinations or imaging conducted for unrelated reasons. These can be solid lesions, such as hemangiomas, focal nodular hyperplasia, hepatic adenomas, or cystic lesions. Recent advancements in MRI technology, particularly with hepatocyte-specific contrast agents, have enhanced the characterization of these lesions, reducing the reliance on invasive tissue sampling. Nevertheless, tissue sampling retains a crucial role in the evaluation of indeterminate lesions or those with malignant potential. While most benign liver lesions are asymptomatic, some can become symptomatic, causing discomfort, pain, or bleeding, particularly if the lesion is large. A deep understanding of the molecular underpinnings of the lesions is crucial for tailoring patient management strategies, particularly in distinguishing lesions that require surgical intervention from those that can be monitored. For instance, the molecular subclassification of hepatic adenomas has provided mechanistic insights and identified certain subtypes that are at higher risk of malignancy. Most benign liver lesions can be safely monitored; however, in patients with cirrhosis or a known primary malignancy, a high index of suspicion for cancer is required. It is crucial to carefully evaluate any liver lesion identified in these patients to ensure that indeterminate lesions are not overlooked. Effective management of benign liver lesions involves a multidisciplinary team, including hepatologists, surgeons, and radiologists, ensuring a comprehensive and individualized approach to patient care. This review outlines the clinical presentation of common benign liver lesions, providing a diagnostic and management framework. Emphasis is placed on a personalized approach to minimize patient distress and optimize outcomes by leveraging imaging advancements and multidisciplinary collaboration.

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来源期刊
Hepatology Communications
Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
8.00
自引率
2.00%
发文量
248
审稿时长
8 weeks
期刊介绍: Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction. ​
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