In The Reading Room with Dr. Richard Semelka - Body MR   •   Episode 6: Inflammatory Liver Disease (PREVIEW VERSION)
Semelka Photo Richard Semelka, M.D.
Professor and Director of Magnetic Resonance Imaging, Vice Chair of Quality and Safety,
University of North Carolina Hospitals, U.S.A

Dr. Semelka is a member of the Editorial Boards of the journals JMRI, MRI and TMRI, and is a reviewer for many journals. He has contributed to over 230 publications in refereed journals and has authored numerous review articles and textbook chapters. He has authored 8 text-books, including Abdominal-Pelvic MRI, third edition, Wiley-Liss, 2010. His main expertise lies in cross sectional abdominal imaging with an emphasis on MRI, with a particular interest of liver, pancreas, kidney and bowel diseases. He regularly conducts various teaching and categorical courses at International Radiology Conferences.

Episode 6: Inflammatory Liver Disease

Case 1: Ovarian Cancer & Lung Metastasis
Case 2: Alcohol Related Chronic Liver Disease
Case 3: PSC, Chronic Liver Disease
Case 4: PSC, Chronic Liver Disease
Case 5: Non-alcoholic Steatohepatitis
Case 6: Autoimmune Hepatitis
Case 7: Primary Biliary Cirrhosis
Case 8: Primary Biliary Cirrhosis
Case 9: Acute Chronic Hepatitis

Episode 6: Inflammatory Liver Disease

CASE 1 FREE PREVIEW ONLY: This program is a “Pay To View” program. To view the entire episode and obtain CME credits you must first purchase the program. Once purchased links will be provided from within your “MyAR Archives” page for access to the program and the online exam to earn CME credit.

Program Summary:

In this episode, Dr. Semelka introduces MRI in regard to imaging the most common causes of cirrhosis in the United States. He describes how to diagnose hepatitis C cirrhosis and how to distinguish acute from chronic hepatitis. He describes the appearance of alcoholic cirrhosis and discusses some of the hallmarks of hepatocellular carcinoma.

Also presented are imaging techniques that he finds useful to detect the presence of iron and fat in abdomen. Lastly, he demonstrates a case in which MRI of the abdomen can be instrumental in determining the presence of acute on Chronic hepatitis.

Case 1: Ovarian Cancer & Lung Metastasis. This patient has hepatitis C Chronic Liver Disease and high grade dysplastic nodule; description is made of evaluating for HCC.

Case 2: Alcohol Related Chronic Liver Disease. This is a case of patient with Alcohol Related Chronic Liver Disease and Acute on Chronic Hepatitis.

Case 3: PSC, Chronic Liver Disease. MRI in Primary Sclerosing Cholangitis is discussed. The ability of MRI to evaluate the full extent of disease is emphasized.

Case 4: PSC, Chronic Liver Disease. This is a case of Primary Sclerosing Cholangitis, and discussion is made of evaluating the distinctive pattern of regeneration of the liver.

Case 5: Non-alcoholic Steatohepatitis. Non-alcoholic steatohepatitis. Discussion is made of NASH becoming one of the most important cases of chronic liver disease.

Case 6: Autoimmune Hepatitis. This is a 39 year-old-woman Autoimmune Hepatitis: the ability of MRI to evaluate the full extent of disease is emphasized.

Case 7: Primary Biliary Cirrhosis. This is a case of primary biliary cirrhosis in a 70 year-old-male.

Case 8: Primary Biliary Cirrhosis. Genetic hemocromatosis with iron deposition in the liver, pancreas, myocardium. The ability of MRI to detect the presence of iron is described.

Case 9: Acute Chronic Hepatitis.This case illustrate the ability of MRI to detect the principal features of Acute on chronic hepatitis.

Approximate Episode Run Time: 63 Minutes

Learning Objectives:

Upon completion of this activity participants will have a better understanding of the following:

• How to construct an MR protocol to fit the patient and clinical questions

• Which MR imaging tools can benefit your review of MRI cases

• Circumstances that can help or hinder your review

• Making the final diagnosis

Claiming CE Credit:

To receive CME credits for participating in this activity you must view the program, successfully complete the online post examination and the following evaluation. Online examinations return an immediate grade report. Upon receiving a passing grade of 70% or higher, a letter of credit will be available for printing and indefinitely available in your “MyAR” Archives.

Accreditation Statement:

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Institute for Advanced Medical Education (IAME) and WebMedEd. IAME is accredited by the ACCME to provide continuing medical education for physicians.

IAME designates this activity for a maximum of one (1) AMA/PRA Category 1 CME Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation.

Program Viewing Instructions:

To begin program review click the appropriate tab above. To start the video presentation, position your cursor over the video player Icon and click. To pause or stop the presentation, position your cursor over the video and click. To view full screen size, cursor over the player to reveal the player controls. Once revealed, click the icon at the far right side of the player with 2 arrows. To advance and rewind the video, click and drag the program timeline to left to rewind and to the right to advance.

System Hardware/Software and Internet Connection Requirements:

The following information is provided for your reference in conjunction with review of this program.

Operating Systems: Windows 2000 or higher, MAC OSX 10.3 or higher.

General System and Internet Requirements: Speakers or Headphones, High Speed Internet connection, Web browsers: Internet Explorer, Firefox, Safari and Chrome.

Disclaimer:

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Episode 6 Case 1 Image

Case 1: Ovarian Cancer & Lung Metastasis. This patient has hepatitis C Chronic Liver Disease and high grade dysplastic nodule; description is made of evaluating for HCC.

Viewing Instructions:

To begin position your cursor over the image above and click. To pause or stop the presentation, position your cursor over the video and click. To view full screen size, cursor over the player to reveal the player controls. Once revealed click the icon at the far right side of the player with 2 arrows. To advance and rewind the video, click and drag the program timeline to left to rewind and to the right to advance.

Episode 6 Case 2 Image

Case 2: Alcohol Related Chronic Liver Disease. This is a case of patient with Alcohol Related Chronic Liver Disease and Acute on Chronic Hepatitis.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.

Episode 6 Case 3 Image

Case 3: PSC, Chronic Liver Disease. MRI in Primary Sclerosing Cholangitis is discussed. The ability of MRI to evaluate the full extent of disease is emphasized.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.

Episode 6 Case 4 Image

Case 4: PSC, Chronic Liver Disease. This is a case of Primary Sclerosing Cholangitis, and discussion is made of evaluating the distinctive pattern of regeneration of the liver.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.

Episode 6 Case 5 Image

Case 5: Non-alcoholic Steatohepatitis. Non-alcoholic steatohepatitis. Discussion is made of NASH becoming one of the most important cases of chronic liver disease.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.

Episode 6 Case 6 Image

Case 6: Autoimmune Hepatitis. This is a 39 year-old-woman Autoimmune Hepatitis: the ability of MRI to evaluate the full extent of disease is emphasized.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.

Episode 6 Case 7 Image

Case 7: Primary Biliary Cirrhosis. This is a case of primary biliary cirrhosis in a 70 year-old-male.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.

Episode 6 Case 8 Image

Case 8: Primary Biliary Cirrhosis. Genetic hemocromatosis with iron deposition in the liver, pancreas, myocardium. The ability of MRI to detect the presence of iron is described.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.

Episode 6 Case 9 Image

Case 9: Acute Chronic Hepatitis. This case illustrate the ability of MRI to detect the principal features of Acute on chronic hepatitis.

Viewing Instructions:

TO VIEW THIS AND THE OTHER CASES IN THIS EPISODE YOU MUST PURCHASE THE PROGRAM.

To select the course for purchase Click Here and add program to cart. Once purchased a link to the full program materials will be provided from within your MyAR Archives section of this website.