(BQ) Part 2 book “Computed body tomography with MRI correlation” has contents: The biliary tract, the pancreas, abdominal wall and peritoneal cavity, the adrenal glands, musculoskeletal system, pediatric applications, and other contents. | 5063_Lee_Ch12pp0829-0930 2/17/06 10:17 AM Page 829 12 Liver Jay P. Heiken Christine O. Menias Khaled Elsayes For more than 25 years, computed tomography (CT) has been widely used for evaluating both focal and diffuse hepatic diseases. It has become established as the imaging method of choice for routine screening of the liver. However, magnetic resonance imaging (MRI) has proved to be at least as effective as intravenous contrast-enhanced CT for detecting and characterizing most hepatic abnormalities. Each method has strengths and limitations. Regardless of the imaging method used, however, the technique of conducting the examination is crucial to its diagnostic performance. This chapter highlights the use of CT and MRI for evaluating both focal and diffuse hepatic abnormalities. Various CT and MRI techniques are discussed, and the rationale for choosing among them in different clinical situations is explained. The clinically relevant anatomy of the liver and the CT and MRI appearances of important pathologic processes involving the liver are detailed. ANATOMY Gross Morphology The liver is the largest organ in the abdomen, occupying most of the right upper quadrant. It varies considerably among individuals in size and configuration. Superiorly, laterally, and anteriorly the liver is bordered by and conforms to the undersurface of the diaphragm. Prominent diaphragmatic leaves may indent the surface of the liver as they insert on the ribs, producing hypoattenuating or lowsignal-intensity defects that should not be misinterpreted as intrahepatic lesions (19) (Fig. 12-1). The liver is bordered medially by the stomach, duodenum, and transverse colon, inferiorly by the hepatic flexure of the colon, and posteriorly by the right kidney. The superior portion of the right adrenal gland borders the medial aspect of the posterior superior right hepatic segment (segment VII). The liver is covered by peritoneum, except for the surfaces apposed to the inferior vena cava .
