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DECLARATION HEPATOBILIARY IMAGING CASE PRESENTATIONS

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Mistakes we all make – Abdominal ImagingUniversity of Toronto
• No financial disclosures or affiliations with commercial organisations
• No discussion of investigational or “off-label” use of medical devices, products or pharmaceuticals
CASE 1 33yr old lady
Hx of renal stones & resected pituitary adenoma (non-
functional) – 2004
Total thyroidectomy
Equilibrium 5min
A. Metastases
B. Adenomas
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3
• Asymptomaic TUMOUR
CT
Insulinoma Subcapsular Hepatic Steatosis Wanless IR et al. Mod Pathol 1989. Khalili K et al. AJR 2002
CT
post colonoscopy. CT
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T2w
T2w-FS
T2w-FS
T1w-OP
T1w-IP
CECT
MNFI
• Multiple
• Rounded/spherical
Struck in abdomen with shopping cart
FAST +ve
Day 1 Day 4
C. Duodenal injury
A. Pancreatic injury
C. Duodenal injury
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A. MRI Liver
B. Ultrasound +/- aspiration
A. MRI Liver
B. Ultrasound +/- aspiration
• Pancreatic head contusion
Common bile duct injury
duct Rt posterior sector duct
• Low insertion of the Rt posterior
sector duct into the CHD
Biliary Variance – 30%
MRI + Primovist
Post-Primo 20min
60min
60min
60min
• Bile leak from three separated ducts (left main, right posterior and
right anterior)
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Primo – 5min Primo – 10min
55yr old man
Bronchoscopy confirmed malignant lesion
B. Adenoma
C. HCC
D. Haemangioma
E. Metastasis
A. Focal Nodular Hyperplasia
METASTASIS – LUNG PRIMARY
METASTASIS – COLONIC PRIMARY Semelka RC et al. Abdom Imaging 1999
SUMMARY
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malignancy or vice-versa
particularly in relation to apparently benign
lesions.
variance
Further Reading
1. Fatty Liver: Imaging Patterns and Pitfalls – Hamer OW et al, Radiographics
2006.
Prasad SR et al, Radiographics 2005.
3. Biliary Imaging: Multi-modality approach to imaging biliary injuries and their
complications – Melamud K et al, Radiographics 2014.
4. Biliary MR imaging with Primovist and its clinical applications - Lee NK,
Radiographics 2009.
Semelka RC, Abdominal Imaging 1999.