Hepatic tumors treated by cryosurgery

Normal CT appearance

Brian S. Kuszyk, Michael A. Choti, Bruce A. Urban, Theodore P. Chambers, David A. Bluemke, James V. Sitzmann, Elliot K. Fishman

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

OBJECTIVE. An understanding of the normal appearance of hepatic tumors treated with cryosurgery is essential for accurately distinguishing normal postoperative changes from potential complications such as hepatic abscess or infarct, which may necessitate further interventions. The purpose of this study was to characterize the normal spectrum of CT findings after cryoablation of hepatic tumors. SUBJECTS AND METHODS. The CT scans of 14 patients who had undergone hepatic cryoablation 4-16 days (mean, 7 days) before scanning were reviewed by three radiologists. None of these patients had postprocedural complications that necessitated intervention (e.g., abscess, infarct, or hemorrhage). Indications for cryoablation included primary hepatic tumors in four patients and hepatic metastases in to patients. CT findings were correlated with surgical findings in a lesion-by- lesion manner to ensure that only cryolesions were included in the analysis. RESULTS. Twenty-eight cryolesions from 3 to 11 cm maximum diameter (mean, 7 cm) were detected on CT scans. All cryolesions were primarily hypodense and extended to the liver capsule. Ten (36%) of 28 lesions contained air, and 26 (93%) of 28 lesions contained hemorrhage. Thirteen (54%) of 24 lesions evaluated with IV contrast material showed peripheral enhancement. Cryolesions were primarily wedge shaped (54%), round (29%), or teardrop shaped (21%). One iatrogenic portosystemic shunt was detected. Other associated findings included subcapsular hemorrhage (29%), perihepatic fluid collections (43%), right-sided pleural effusion (93%), left-sided pleural effusion (64%), atelectasis of one or both lungs (93%), and ascites (7%). CONCLUSION. The postoperative CT appearance of the liver in patients who underwent hepatic cryoablation without complications mimics that seen in the liver of patients with hepatic abscesses or infarcts. The CT appearance of the liver in patients undergoing cryosurgery needs to be carefully analyzed to avoid confusing normal findings related to the procedure with those related to procedural complications. It may be impossible to differentiate hepatic complications from normal postoperative changes on the basis of CT findings in many of these patients.

Original languageEnglish (US)
Pages (from-to)363-367
Number of pages5
JournalAmerican Journal of Roentgenology
Volume166
Issue number2
StatePublished - Feb 1996

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Cryosurgery
Liver
Neoplasms
Liver Abscess
Pleural Effusion
Hemorrhage
Surgical Portasystemic Shunt
Pulmonary Atelectasis
Ascites
Abscess
Contrast Media
Capsules
Air
Neoplasm Metastasis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Kuszyk, B. S., Choti, M. A., Urban, B. A., Chambers, T. P., Bluemke, D. A., Sitzmann, J. V., & Fishman, E. K. (1996). Hepatic tumors treated by cryosurgery: Normal CT appearance. American Journal of Roentgenology, 166(2), 363-367.

Hepatic tumors treated by cryosurgery : Normal CT appearance. / Kuszyk, Brian S.; Choti, Michael A.; Urban, Bruce A.; Chambers, Theodore P.; Bluemke, David A.; Sitzmann, James V.; Fishman, Elliot K.

In: American Journal of Roentgenology, Vol. 166, No. 2, 02.1996, p. 363-367.

Research output: Contribution to journalArticle

Kuszyk, BS, Choti, MA, Urban, BA, Chambers, TP, Bluemke, DA, Sitzmann, JV & Fishman, EK 1996, 'Hepatic tumors treated by cryosurgery: Normal CT appearance', American Journal of Roentgenology, vol. 166, no. 2, pp. 363-367.
Kuszyk BS, Choti MA, Urban BA, Chambers TP, Bluemke DA, Sitzmann JV et al. Hepatic tumors treated by cryosurgery: Normal CT appearance. American Journal of Roentgenology. 1996 Feb;166(2):363-367.
Kuszyk, Brian S. ; Choti, Michael A. ; Urban, Bruce A. ; Chambers, Theodore P. ; Bluemke, David A. ; Sitzmann, James V. ; Fishman, Elliot K. / Hepatic tumors treated by cryosurgery : Normal CT appearance. In: American Journal of Roentgenology. 1996 ; Vol. 166, No. 2. pp. 363-367.
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abstract = "OBJECTIVE. An understanding of the normal appearance of hepatic tumors treated with cryosurgery is essential for accurately distinguishing normal postoperative changes from potential complications such as hepatic abscess or infarct, which may necessitate further interventions. The purpose of this study was to characterize the normal spectrum of CT findings after cryoablation of hepatic tumors. SUBJECTS AND METHODS. The CT scans of 14 patients who had undergone hepatic cryoablation 4-16 days (mean, 7 days) before scanning were reviewed by three radiologists. None of these patients had postprocedural complications that necessitated intervention (e.g., abscess, infarct, or hemorrhage). Indications for cryoablation included primary hepatic tumors in four patients and hepatic metastases in to patients. CT findings were correlated with surgical findings in a lesion-by- lesion manner to ensure that only cryolesions were included in the analysis. RESULTS. Twenty-eight cryolesions from 3 to 11 cm maximum diameter (mean, 7 cm) were detected on CT scans. All cryolesions were primarily hypodense and extended to the liver capsule. Ten (36{\%}) of 28 lesions contained air, and 26 (93{\%}) of 28 lesions contained hemorrhage. Thirteen (54{\%}) of 24 lesions evaluated with IV contrast material showed peripheral enhancement. Cryolesions were primarily wedge shaped (54{\%}), round (29{\%}), or teardrop shaped (21{\%}). One iatrogenic portosystemic shunt was detected. Other associated findings included subcapsular hemorrhage (29{\%}), perihepatic fluid collections (43{\%}), right-sided pleural effusion (93{\%}), left-sided pleural effusion (64{\%}), atelectasis of one or both lungs (93{\%}), and ascites (7{\%}). CONCLUSION. The postoperative CT appearance of the liver in patients who underwent hepatic cryoablation without complications mimics that seen in the liver of patients with hepatic abscesses or infarcts. The CT appearance of the liver in patients undergoing cryosurgery needs to be carefully analyzed to avoid confusing normal findings related to the procedure with those related to procedural complications. It may be impossible to differentiate hepatic complications from normal postoperative changes on the basis of CT findings in many of these patients.",
author = "Kuszyk, {Brian S.} and Choti, {Michael A.} and Urban, {Bruce A.} and Chambers, {Theodore P.} and Bluemke, {David A.} and Sitzmann, {James V.} and Fishman, {Elliot K.}",
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T2 - Normal CT appearance

AU - Kuszyk, Brian S.

AU - Choti, Michael A.

AU - Urban, Bruce A.

AU - Chambers, Theodore P.

AU - Bluemke, David A.

AU - Sitzmann, James V.

AU - Fishman, Elliot K.

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N2 - OBJECTIVE. An understanding of the normal appearance of hepatic tumors treated with cryosurgery is essential for accurately distinguishing normal postoperative changes from potential complications such as hepatic abscess or infarct, which may necessitate further interventions. The purpose of this study was to characterize the normal spectrum of CT findings after cryoablation of hepatic tumors. SUBJECTS AND METHODS. The CT scans of 14 patients who had undergone hepatic cryoablation 4-16 days (mean, 7 days) before scanning were reviewed by three radiologists. None of these patients had postprocedural complications that necessitated intervention (e.g., abscess, infarct, or hemorrhage). Indications for cryoablation included primary hepatic tumors in four patients and hepatic metastases in to patients. CT findings were correlated with surgical findings in a lesion-by- lesion manner to ensure that only cryolesions were included in the analysis. RESULTS. Twenty-eight cryolesions from 3 to 11 cm maximum diameter (mean, 7 cm) were detected on CT scans. All cryolesions were primarily hypodense and extended to the liver capsule. Ten (36%) of 28 lesions contained air, and 26 (93%) of 28 lesions contained hemorrhage. Thirteen (54%) of 24 lesions evaluated with IV contrast material showed peripheral enhancement. Cryolesions were primarily wedge shaped (54%), round (29%), or teardrop shaped (21%). One iatrogenic portosystemic shunt was detected. Other associated findings included subcapsular hemorrhage (29%), perihepatic fluid collections (43%), right-sided pleural effusion (93%), left-sided pleural effusion (64%), atelectasis of one or both lungs (93%), and ascites (7%). CONCLUSION. The postoperative CT appearance of the liver in patients who underwent hepatic cryoablation without complications mimics that seen in the liver of patients with hepatic abscesses or infarcts. The CT appearance of the liver in patients undergoing cryosurgery needs to be carefully analyzed to avoid confusing normal findings related to the procedure with those related to procedural complications. It may be impossible to differentiate hepatic complications from normal postoperative changes on the basis of CT findings in many of these patients.

AB - OBJECTIVE. An understanding of the normal appearance of hepatic tumors treated with cryosurgery is essential for accurately distinguishing normal postoperative changes from potential complications such as hepatic abscess or infarct, which may necessitate further interventions. The purpose of this study was to characterize the normal spectrum of CT findings after cryoablation of hepatic tumors. SUBJECTS AND METHODS. The CT scans of 14 patients who had undergone hepatic cryoablation 4-16 days (mean, 7 days) before scanning were reviewed by three radiologists. None of these patients had postprocedural complications that necessitated intervention (e.g., abscess, infarct, or hemorrhage). Indications for cryoablation included primary hepatic tumors in four patients and hepatic metastases in to patients. CT findings were correlated with surgical findings in a lesion-by- lesion manner to ensure that only cryolesions were included in the analysis. RESULTS. Twenty-eight cryolesions from 3 to 11 cm maximum diameter (mean, 7 cm) were detected on CT scans. All cryolesions were primarily hypodense and extended to the liver capsule. Ten (36%) of 28 lesions contained air, and 26 (93%) of 28 lesions contained hemorrhage. Thirteen (54%) of 24 lesions evaluated with IV contrast material showed peripheral enhancement. Cryolesions were primarily wedge shaped (54%), round (29%), or teardrop shaped (21%). One iatrogenic portosystemic shunt was detected. Other associated findings included subcapsular hemorrhage (29%), perihepatic fluid collections (43%), right-sided pleural effusion (93%), left-sided pleural effusion (64%), atelectasis of one or both lungs (93%), and ascites (7%). CONCLUSION. The postoperative CT appearance of the liver in patients who underwent hepatic cryoablation without complications mimics that seen in the liver of patients with hepatic abscesses or infarcts. The CT appearance of the liver in patients undergoing cryosurgery needs to be carefully analyzed to avoid confusing normal findings related to the procedure with those related to procedural complications. It may be impossible to differentiate hepatic complications from normal postoperative changes on the basis of CT findings in many of these patients.

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