title: Limitations of angiographic differential diagnosis in major hepatic processes.
abstract: In 11 instances (6%) of 183 consecutive hepatic angiograms done for subsequently proven pathologic hepatic processes, either the diagnosis was incorrect (4 patients) or a satisfactory differential diagnosis was not established (7 patients), despite obvious angiographic abnormalities. Incorrect diagnoses were made in patients with suppurative hapatocarcinoma and liver cyst, macronodular regenerative cirrhosis, and multiple intrahepatic abscesses. Satisfactory differential diagnoses could not be established in patients with enlarged intrahepatic ducts, acute viral hepatitis, recurrent cirrhosis and acute liver necrosis. On analysis, means for minimizing diagnostic failure include the use of enhancement techniques such as infusion angiography and pharmacoangiography and an unbiased, detailed analysis of the angiographic findings. Changes secondary to the pathologic process and the coexistence of multiple processes, however, can occasionally prevent an accurate diagnosis.
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000000981:diagnostic imaging; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D056486:Chemical and Drug Induced Liver Injury / Q000000981:diagnostic imaging; D003560:Cysts / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006525:Hepatitis, Viral, Human / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000000981:diagnostic imaging; D008099:Liver / Q000473:pathology; D008100:Liver Abscess / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000000981:diagnostic imaging; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging