CT of the liver with US, MR imaging, and anglographic correlation

The purpose of this paper is to synthesize information on the numerous advances in liver imaging over recent years, particularly as they relate to CT scanning. The relative indications and complementary uses of dynamic CT with intravenous contrast agent enhancement, delayed scanning after contrast agent injection, CT-guided angiography, US, angiography, and MR imaging are illustrated. The techniques for performing the CT examinations and statistics regarding accuracy are presented. In the search for focal or diffuse liver disease, dynamic CT is often the first test employed. CT-guided angiography and delayed CT are used when depicting the exact number and location of lesions is crucial for surgical planning. US is commonly used as a directed examination to resolve uncertainties about CT results. The indications for angiography are discussed. Preliminary work with MR imaging suggests its value in detecting focal liver lesions and specifically in diagnosing hepatic hemangiomas. As most methods of liver imaging have improved, the complexity of diagnostic decision-making has also increased. This course is intended to help clarify the approach to focal and diffuse liver diagnosis in specific clinical circumstances