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CC BY-NC-ND 4.0 · Revista Argentina de Radiología / Argentinian Journal of Radiology 2018; 82(01): 013-027
DOI: 10.1055/s-0038-1637027
Review Article | Revisión de Tema
Sociedad Argentina de Radiología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Agentes hepatoespecíficos, usos actuales: más allá de la caracterización de lesiones focales

Hepatospecific Agents, Current Uses: More than the Characterization of Focal Lesions
G. A. Castrillón
1   Medico Radiólogo, Especialista en Imagen Corporal, Profesor Titular, Departamento de Radiología y Grupo de Gastrohepatología, Universidad de Antioquia, Medellín, Colombia
,
J. P. Espinosa
2   Radiólogo, CES, Fellow en Imagen Corporal, Universidad de Antioquia, Medellín, Colombia
,
M. Noriega P.
3   Mónica Noriega P., Residente de Radiología, Universidad de Antioquia, Medellín, Colombia
,
M. Royero
4   Mónica Royero, Radióloga, Universidad de Antioquia, Medellín, Colombia
,
D. V. Gómez
5   Diana V Gómez, Medica Radióloga, Especialista en Imagen Corporal, Universidad de Antioquia, Medellín, Colombia
› Author Affiliations
Further Information

Publication History

21 March 2017

06 August 2017

Publication Date:
16 April 2018 (online)

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Resumen

Con el ácido gadoxético, el realce dinámico de las lesiones focales es igual a los demás medios de contraste extracelulares, por lo que su utilidad principal está en la obtención de una fase hepatobiliar que permita diferenciar y caracterizar lesiones que contienen hepatocitos como en el caso de la hiperplasia nodular focal (HNF) y los nódulos regenerativos. Las lesiones que no tienen hepatocitos o que son carentes de conductos biliares, demuestran baja señal con respecto al parénquima hepático en esa fase, lo que ocurre con los adenomas hepatocelulares (AHC), nódulos displásicos de alto grado, carcinoma hepatocelular (CHC) y metástasis entre otras. Hacer esta diferenciación cambia el manejo de la lesión focal, permitiendo en la mayoría de los casos caracterizar las lesiones que contienen hepatocitos que no requieren biopsia, como las benignas, de aquellas que si pudieran requerir la confirmación histológica. Otros usos de estos medios de contraste órgano específicos es la evaluación de la integridad de la vía biliar especialmente en pacientes posquirúrgicos y la diferenciación de quistes que tienen comunicación con la vía biliar de aquellos que son quistes hepáticos simples.

El objetivo de este artículo es realizar una revisión sobre la evidencia actual del papel emergente de los contrastes órgano específicos, incluyendo no solo la evaluación de las lesiones focales hepáticas, sino también otras utilidades como el análisis de la patología biliar.

Abstract

With gadoxetic acid the dynamic enhancement of the lesions is equal to the other extracellular contrast agents. Its main utility is in obtaining a hepatobiliary phase that allows to characterize the lesions that contain functional hepatocytes as it would be the case of the regenerative nodules and focal nodular hyperplasia.

Lesions without functional hepatocytes or that are devoid of bile ducts appear hypointense with respect to the hepatic parenchyma at this stage, which occurs in adenoma, high-grade dysplastic nodules, hepatocarcinoma, and metastases among others. Making this differentiation, the management of the focal lesion would change, allowing us, in most cases, characterizing lesions containing functional hepatocytes as benign and therefore that dońt require biopsy, of those that may require histological confirmation.

Other uses of these contrast media are the evaluation of the integrity of the bile duct especially in post-surgical stages and the differentiation of cysts that have communication with the bile duct of those who are simple hepatic cysts.

The objective of this article is to perform a review of the current evidence about the emergent role of organ specific agents, not only for the evaluation of liver focal lesions, but also other utilities such as analysis of biliary pathology.

Palabras Clave

hígado - medio de contraste - resonancia magnética

Keywords

liver - contrast media - magnetic resonance imaging

Responsabilidades éticas

Protección de personas y animales. Los autores declaran que para esta investigación no se han realizado experimentos en seres humanos ni en animales.


Confidencialidad de los datos. Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicación de datos de pacientes.


Derecho a la privacidad y consentimiento informado. Los autores declaran que en este artículo no aparecen datos de pacientes.


 

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