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!"#$%&(%)#(*+$+,-#./0*1+2342546789:;<                        ARTÍCULO DE REVISIÓNDr. Gaspar Alberto Motta Ramírez*Dra. Eri...
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Caracterizacion de lesiones focales hepaticas por TCMD

CARACTERIZACION DE LESIONES FOCALES HEPATICAS POR TOMOGRAFIA COMPUTADA MULTIDETECTORES

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Caracterizacion de lesiones focales hepaticas por TCMD

  1. 1. !"#$%&(%)#(*+$+,-#./0*1+2342546789:;< ARTÍCULO DE REVISIÓNDr. Gaspar Alberto Motta Ramírez*Dra. Erika Alonso Blancas** !"#"$%&#("$)*+,&+-&./*&.+Ruby Ann Chirino Sprung*Lluvia Irais González-Merino* 0&12%$".+3/$"-&.+$/*+%/4/5#"36"+ $/417%","+47-%,&%&$%/# RESUMEN CA6W+ %]*26+ ^%+ /#23R)+ N3$#&Q%2­ %&#&3*Q#)*2%+#)+N#(%).3*(%2+ :8/%&+I#)3.)%+(O2+P&#:8#)#+P8#+ M;+#)+#/+:%&:3)*(%+N#$%*:#/8­ 89:&%;/<+ 7%&%:#&3K%&+ /%2+ #/+N#(%).3*(%;+,#(*2&%,*+#)+ /%&;+ /%+ ,#(*2&%:3R)+ ,#+ &*(­ /#23*)#2+ N#$O3:%2+ P*:%/#2+ ,#­ A[+ $%:3#)#2+ UWBZV+ M+ /%+ /#23R)+ I*232+ $*&%/+ M+ /*2+ :%(I3*2+ $*&+ #:%,%2+M+#Q%/8%,%2+:*)+*(*­ (%/3.)%+(O2+P&#:8#)#+P8#+#/+N#­ N#$%*$%0%+%2*:3%,%6 .&%P0%+:*($8%,%+(8/3,##:*&6 patocarcinoma en 12 pacientes  !/*$-7./*&.G+^%+*(*.&%­ ="%&#"-+ >+ 4?%/,/.<+ 9#+ UAY6XZV6+^%+/#23R)+N3$*Q%2:8/%&+ P0%+ :*($8%,%+ (8/3,##:*&+ &#%/3KR+ 8)+ #28,3*+ &#&*2$#:­ I#)3.)%+ (O2+ P&#:8#)#+ P8#+ #/+ #2+ #/+ (#*&+ (D*,*+ $%&%+ /%+ 3Q*;+ ,#2:&3$3Q*+ M+ ,*I/#+ :3#.*+ _832#+ N#$O3:*+ 23($/#+ US+ $%­ :%&%:#&3K%:3R)+,#+/%2+/#23*)#2+ ,*),#+2#+&#Q32%&*)+ST+#28,3*2+ :3#)#2;+`6[ZV+M+/%+(%/3.)%+P8#+/%+ N#$O3:%2+P*:%/#26 ,#+*(*.&%P0%+:*($8%,%+(8/­ /#23R)+(#%2O23:%+US+$%:3#)#2;+ 3,##:*&+U@7?"V+,#+%I,*(#)+ `6[ZV6+ ^%+ /#23R)+ 2#8,*8(*&%/+ A"-"9#".+$-";&G+/#23R)+N#$O­ &#%/3K%,*2+ #)+ )8#2&*+ N*2$3%/+ (O2+ P&#:8#)#+ P8#+ #/+ %I2:#2*+ 3:%+P*:%/;+N#(%).3*(%+N#$O3:*;+ #)+#/+$#&3*,*+,#+P#I&#&*+,#+WBAB+ N#$O3:*+UAA+$%:3#)#2;+AX6AZV6+ N#$%*:%&:3)*(%;+ *(*.&%P0%+ %+P#I&#&*+,#+WBAA6 a/+ /RI8/*+ N#$O3:*+ ,#&#:N*+ P8#+ :*($8%,%+(8/3,##:*&6 @&.7-%",/.<+ 9#+ %)%/3K%&*)+ #/+(O2+%P#:%,*+UTS+$%:3#)#2;+ WX+UCYZV++N*(I&#2+M+[X+UTWZV+ XWZV6+^*2+N%//%K.*2+%,3:3*)%/#2+ (8#&#2+:*)+#,%,+$&*(#,3*+,#+ P8#&*)+/%+3,#)3b:%:3R)+,#+P028/%+ !"#$%#&()#(*(+,-.(/0!"#$%&%(#)*+,#+-(%.#)*/*.0%+,#/+1*2$3%/+4).#/#2+,#/+5#,&#.%/6!!78&2*+,#+$*2.&%,*+,#+-(%.#)+9#::3*)%/;+<=>?6 /%2+$#),3#)#2+,#+/%+:8&Q%+%*&3:%+M+$%&#)_83(%*2%+7%(3)*+%+9%)%+@#&#2%+=*6+ABCC;+7*/6+1D&*#2+,#+5%,3#&)%;+?DE3:*;+"6F6 2#+ *&)%)+ $%&%/#/%21+ Ub.8&%+ AV6+ ^%2+ /#23*)#2+ P*:%/#2+7*&&#2$*),#):3%G+"&6+H%2$%&+>/I#&*+?*%+J%(0&#KG+.%(*%&LM%N**6:*(6(E N#$O3:%2+ U^F1V+ 2#+ N%)+ :%%/*.%,*+ :*(*+ N3$#&Q%2­ :8/%&;+N3$*Q%2:8/%&;+I#)3.)%;+(%/3.)%+M+2#8,*8(*&%/+B*%#/,7$$)* U:8%,&*+-V6 ^%+ *(*.&%P0%+ :*($8%,%+ (8/3,##:*&+ U@7?"V+ a)+/%+/#23R)+N3$#&Q%2:8/%&+/%+3&&3.%:3R)+,#$#),#+:%23+N%:#+P%:3I/#+#/+#28,3*+,#/+$%&D)_83(%+N#$O3:*+$*2­ #E:/823Q%(#)#+,#+/%+%&#&3%+N#$O3:%2+(3#)&%2+_8#+#)+:*)&%2#+-c+#)+T+P%2#2+,#+&#P*&K%(3#)*6+^*2+$&3(#&*2+ /%+N3$*Q%2:8/%&+/%+3&&3.%:3R)+,#$#),#+,#+/%+Q#)%+$*&%+Q%2*2+N#$O3:*2+#)+&#P*&K%&+2*)+/*2+%&#&3%/#2+,#+AC+%+ M+#2+$*&+#//*+_8#+/%+*$%:3b:%:3R)+,#+/%+^F1+$*2#&3*&+WC+2#.8),*2+UP%2#+%&#&3%/+N#$O3:%+$&#:*KV+,#2$8D2+ %/+:*)&%2#+#2+(O2+/#)%+M+2#+$&*,8:#+N%:3%+/%+P%2#+,#+/%+3)M#::3R)+3)&%Q#)*2%+,#/+(#,3*+,#+:*)&%2#d+/%+ ,#+#_83/3I&3*62Q#)%+$*&%+&#P8#&K%+,#+/*2+[C+%+/*2+TB+2#.8),*2+UP%2#+%&#&3%/+N#$O3:%+%&,0%+*+P%2#+,#+e8*+$*&%/V+(3#)&%2+ 89:&%;/_8#+/%2+ Q#)%2+ N#$O3:%2+ 28#/#)+N%:#&/*+#)&#+/*2+SB+ A6+ aQ%/8%&+/%+83/3,%,+,#+/%+@7?"+$%&%+/%+:%&%:#&3K%­M+XB+2#.8),*2+UP%2#+$%&#)_83(%*2%+N#$O3:%+*+P%2#+ :3R)+,#+/%2+/#23*)#2+P*:%/#2+N#$O3:%26Q#)*2%+N#$O3:%V6+a)&#+/*2+2#.8),*2+`B+M+ACB+%$%&#­ W6+ J#Q32%&+/*2+N%//%K.*2+$*&+3(%.#)+,#+/*2+,3P#&#)#2+:#+/%+P%2#+,#+#_83/3I&3*+_8#+2#+N%+,#b)3,*+%+&%QD2+,#+ 3$*2+,#+/#23R)+P*:%/+N#$O3:%+M+:*)+#//*+:%&%:#&3­:8&Q%2+3#($*f,#)23,%,+#+3),3:%)+#/+(*(#)*+#)+_8#+ K%&/%2+:*)+$&#:323R)+$*&+(#,3*+,#+@7?"646 Enero­Marzo 2012
  2. 2. 1%)#)(2)(*(+,-.(/3 %3)#,;+ g3N+ %Q#&%.#+ %.#+ *P+ %PP#:#,;+3)+TS+:%2#2+UXWZV6+>,­ CA6W+ M#%&26+ N#+ (*2+ :*((*)+ ,33*)%/+b),3).2+g#&#+3,#)3b:%­ I#)3.)+NM$#&Q%2:8/%&+/#23*)+g%2+ 3*)+*P+%&#&3*Q#)*82+b28/%2+3)+ ABSTRACT N#(%).3*(%;+P*8),+3)+A[+:%2#2+ N#(%).3*(%2+%),+3)+177;+%$­ UWBZV;+ %),+ N#+ (*2+ :*((*)+ $#%&%):#+ *P+ $*&%/+ N&*(I*232;+ A7#1/.&<+7N%&%:#&3K#+P*:%/+ (%/3.)%)+NM$#&Q%2:8/%&+/#23*)+ %),+:N%).#2+,8#+*+%22*:3%#,+ N#$%3:+ /#23*)2+ ,##:#,+ %),+ g%2+ N#$%*:%&:3)*(%;+ P*8),+ N#$%*$%NM6 #Q%/8%#,+IM+(8/3$N%2#+?"7@6 3)+ AW+ :%2#2+ UAY6XZVd+ N#+ (*2+ !/*$-7./*.G+ ?8/3$N%2#+ ="%&#"-+"*,+4&%0/,.<+A ret­ :*((*)+ I#)3.)+ NM$*Q%2:8/%&+ ?"7@+ 32+ N#+ I#2+ (#N*,+ *P+ &*2$#:3Q#;+ ,#2:&3$3Q#;+ ,*8I/#+ /#23*)+ g%2+ 23($/#+ N#$%3:+ :M2+ :N*3:#+ P*&+ :N%&%:#&3K%3*)+ *P+ I/3),+ 28,M+ g%2+ :*),8:#,;+ P*8),+3)+S+:%2#2+U`6[ZV;+%),+N#+ P*:%/+N#$%3:+/#23*)26 gN3:N+ &#Q3#g#,+ ST+ (8/3$N%2#+ (*2+:*((*)+(%/3.)%)+NM$*­ ?"7@+ %I,*(3)%/+ 28,3#2+ $#&­ Q%2:8/%&+ /#23*)+ g%2+ (#%2%3:+ P*&(#,+%+*8&+N*2$3%/+3)+N#+$#­ /#23*);+P*8),+3)+S+:%2#2+U`6[ZVd+ &3*,+P&*(+F#I&8%&M+WBAB+N&*8.N+ N#+ (*2+ :*((*)+ $2#8,*8­ C&>+ D/#,.G+ F*:%/+ N#$%3:+ F#I&8%&M+WBAA6 (*&%/+/#23*)+g%2+/3Q#&+%I2:#22;+ /#23*);+ N#$%3:+ N#(%).3*(%;+ @&.7-%.<+WX+UCYZV+(#)+%),+ P*8),+3)+AA+:%2#2+UAX6AZV6+@N#+ N#$%*:%&:3)*(%;+(8/3,##:*&+ [X+ UTWZV+ g*(#)+ g#&#+ *I­ &3.N+N#$%3:+/*I#+g%2+N#+(*2+ :*($8#,+*(*.&%$NM6="%&#"-+>+4?%/,/. *+I%&3*Vd+,#2$8D2;+:*)+:%D#&+WBH+2#+3)M#:*+2*/8:3R)+ 9#+ &#%/3KR+ 8)+ #28,3*+ &#&*2$#:3Q*;+ ,#2:&3$3Q*+ M+ 2%/3)%+U[B+(/V+$%&%+:*&&*I*&%&+/%+$#&(#%I3/3,%,+Q#)*2%6+,*I/#+ :3#.*+ ,*),#+ 2#+ &#Q32%&*)+ S+ BBB+ #28,3*2+ ,#+ 5*2#&3*&(#)#+2#+3)M#:%&*)+ACB+(/+,#+(#,3*+,#+:*)­@7?"+ &#%/3K%,*2+ #)+ )8#2&*+ N*2$3%/+ U$&3Q%,*+ M+ ,#+ &%2#+-c+)*+3R)3:*+Uh$3&%M! y @&#Q32!V+:*)+[WB+(.+,#+&#P#&#):3%V+#)+#/+$#&3*,*+,#+8)+%]*+:*($&#),3,*+#)&#+ M*,*+$*&+(3/3/3&*+83/3K%),*+8)+3)M#:*&+%8*(O3:*+,8%/+P#I&#&*+,#+WBAB+M+P#I&#&*+,#+WBAA6+9#+3,#)3b:%&*)+,3­ %+[+(/i26+9#+*I8Q3#&*)+:*&#2+%+/*2+AC+2+$%&%+/%+P%2#+P#&#)#2+3$*2+,#+^F1+:*)+,*2+#_83$*2+,#+@7?"+UHa!" %&#&3%/+*+%/+&#P*&K%(3#)*+,#+ABB+<1+,#+/%+%*&%;+%+/*2+?#,3:%/+ 9M2#(2+ ,#+ Y+ :*&#2+ M+ 93#(#)2!+ "#b)33*)+ WC+2+2#+*I8Q*+8)%+P%2#+Q#)*2%+M+%+/*2+[C+2+8)%+P%2#+"8%/+ 9*8&:#V+ 83/3K%),*+ $&**:*/*+ %I,*(3)*$D/Q3:*G+ $*&%/6+ a)+ :%2*2+ )#:#2%&3*2+ 2#+ *I8Q3#&*)+ 3(O.#)#2+P%2#+23($/#+:*)+3)#&Q%/*2+,#+AB+((+M+WB+((+,#+#2­ %+/*2+SB+2+$%&%+/%+:%&%:#&3K%:3R)+,#+/%2+/#23*)#26+^%2+$#2*&+$&#Q3%+3).#2%+,#+:*)&%2#+*&%/+UM*,%,*;+%.8%+ 3(O.#)#2+P8#&*)+%)%/3K%,%2+$*&+,*2+(D,3:*2+&%,3R/*­ 12 1 () (* (+ (, Aorta (- (. (/ (2 2:gado (1 1SegundosE57#"+FG+F%2#2+N#$O3:%2;+$*2#&3*&#2+%+/%+%,(3)32&%:3R)+,#/+(#,3*+,#+:*)&%2#+-c;+#)+3#($*+U2#.8),*2V+M+&#P*&K%(3#)*+#)+8)3,%,#2+1*8)2b#/,+U<1V6 Enero­Marzo 2012 47
  3. 3. !7",#/+BG+7/%23b:%:3R)+,#+/%2+/#23*)#2+N#$O3:%2+$*&+28+3$*+,#+&#%/:# H74/#&.+0&12%$/.+01&#;".$7-"#&. ?%/3.)*2 k#)3.)*2 ++++5&3(%&3*2 ++++++++++1#(%).3*(%+U(#)*&+,#+A+:(V ++++++++1#$%*:%&:3)*(%+U(#)*&+,#+[+:(V ++++++++++>).3*(3*/3$*(%2+ ++++++++7%&:3)*(%+,#+bI&*/%(#/%& ++++++++++13$#&$/%23%+)*,8/%&+P*:%/ ++++++++1#$%*I/%2*(%2+U)3]*2V      ++?#O2%232 ++++++++?#/%)*(% ++++++++7O):#&+,#+(%(% ++++++++7%&:3)*(%+&#)%/ ++++++++7%&:3)*3,#         Leiomiosarcoma ++++++++7%&:3)*(%+(#,8/%&+,#+3&*3,#2 ++++++++7%&:3)*(%+,8:%/+,#+$O):&#%2 ++++++++7%&:3)*(%+,#+$O):&#%2 ++++++++7%&:3)*(%+,#+:*/*) H74/#&.+0&12%$/.+01/;".$7-"#&. ?%/3.)*2 k#)3.)*2     732*%,#)*:%&:3)*(%+ ++++l832*%,#)*(% ++++?#O2%232+N3$*Q%2:8/%&#2 ++++@3$*+_8023:*2+ ++++++++7%&:3)*(%+:*/*&&#:%/ ++++++++l832#2+N#$O3:*2+ ++++++++7%&:3)*(%+,#+:D/8/%2+&%)23:3*)%/#2 ++++++++l832#2+:3/3%,*2+,#/+3)#23)*+%)#&3*& ++++^3)P*(%+     Hamartomas     Adenocarcinomas     Lipomas ++++l832#2+,#+:*/D,*:* I&./*&.+.&7,/%74/#"-&.+0&12%$". a2#%*232+N#$O3:%+P*:%/;+2%&:*3,*232;+3)P#::3*)#2+.&%)8/*(%*2%2+*+$*&+N*).*2;+2#8,*8(*&+3)e%(%*&3* >I2:#2*+N#$O3:*+3)3:3%/.*2+ U(D*,*+ ,*I/#+ :3#.*V+ M+ %/.8)%2+ /#23*)#2+ P8#&*)+ 9#+#E:/8M#&*)+/*2+$%:3#)#2+_8#+$&#2#)%&*)+/#23*)#2+:%&%:#&3K%,%2+$*&+28+:*($*&%(3#)*+(3#)&%2+_8#+#)+ N#$O3:%2+(j/3$/#2+*+,3P82%2;+$&#Q3%(#)#+:*)*:3,%2;+*&%2+2#+&#_83&3R+/%+*(%+,#+I3*$23%+$%&%+:*&&*I*&%&+#/+ I%*+2#.83(3#)*+*+_8#+)*+:*)%&*)+:*)+#28,3*+,3)O­,3%.)*23:*6+a/+%)O/3232+#2%,023:*+3):/8MR+#/+#28,3*+M+ (3:*+,#+@7?"6%)O/3232+,#/+#E$#,3#)#+:/0)3:*+,#+/*2+$%:3#)#2G+,%*2+  ,#(*.&Ob:*2+ IO23:*2+ U#,%,+ M+ 2#E*V;+ 20)*(%2+ _8#+ @&.7-%",/.(*3Q%&*)+/%+2*/3:38,+,#/+#28,3*+,#+3(%.#)+U*(*.&%­ a/+%)O/3232+,#+/%2+3(O.#)#2+,#+:%,%+$%:3#)#+$*&+P8#+P0%+ *+ &#2*)%):3%V+ %20+ :*(*+ _8D+ #28,3*2+ ,#+ 3(%.#)+ &#%/3K%,*+$*&+,*2+(D,3:*2+&%,3R/*.*26+9#+2#/#::3*)%&*)+2#+&#%/3K%&*)+M+N%//%K.*2+#2$#:0b:*2 %+/%+/#23R)+P*:%/+ M+%)%/3K%&*)+ST+$%:3#)#2+:*)+^F1+,##:%,%+$*&+(#,3*+N#$O3:%+&#%4+%/#2+:*(*G+(#,3,%2+,#+/%+/#23R);+233*+ ,#+8)+#28,3*+,3)O(3:*+,#+@7?"+(8/3PO23:%+M+:*)+/%+N#$O3:*+,#+(%M*&+:*($&*(32*;+$&#2#)%:3R)+:/0)3:%+ 3)P*&(%:3R)+:/0)3:%+$#&3)#)#+U:*&&#2$*),3#)#2+%+AZ+,#+ /%+ /#23R)+ %/+ 2#&+ 3,#)3b:%,%+ :*(*+ 3):3,#)%/+ *+ )*+ ,#/+8)3Q#&2*+,#+$%:3#)#2V6+F8#&*)+WX+N*(I&#2+UCYZV+3):3,#)%/+ U3),3:%:3R)+ :/0)3:%+ _8#+ (*3Q%+ #/+ #28,3*V;+ M+[X+(8#&#2+UTWZV+#)+8)+&%).*+,#+#,%,#2+#)&#+AT+N#$%*$%0%+ U#)+ 28+ :%2*V;+ :%/:3b:%:3*)#2+ %2*:3%,%2;+ %]*2+M+YS+%]*2+U$&*(#,3*+,#+CA6W+%]*2+M+8)%+(#,3%+,#+%2:332+*+,#&&%(#+$/#8&%/6+9#+:*)23,#&R+#/+&#P*&K%(3#)*+ CB6C+%]*2V+:*)+/*2+23.83#)#+3)#&Q%/*2+,#+P&#:8#):3%+$*&+,#+/%+^F1+#)+/%2+P%2#2+23($/#;+%&#&3%/+M+$*&%/+:%&%:#­ #,%,G+,#+AT+%+W[+%]*2+W+U[6AZV;+W[+%+[W+%]*2+Y+UAW6CZV;+&3KO),*/%2+#)+N3$*Q%2:8/%+N3$#&Q%2:8/%&#2+M+#2%2;+ [W+%+TA+%]*2+A[+UWB6[ZV;+TA+%+CB+%]*2+`+UATZV;+CB+%+%+ 28+ Q#K;+ #)+ (%/3.)%2;+ I#)3.)%2+ *+ 2#8,*8(*&%/#26+ C`+%]*2+`+UATZV;+C`+%+SY+%]*2+X+UAB6`ZV;+SY+%+XX+%]*2+48 Enero­Marzo 2012
  4. 4. AW+UAY6XZV+M+,#+XX+%+YS+%]*2+T+US6WZV6++a)+WY+$%:3#)­ &3*Q#)*2%2+2#+$&#2#)%&*)+#)+/*2+717+:*)+8)+%(%]*+#2+UTTZV+/*2+N%//%K.*2+P8#&*)+3):3,#)%/#2+M;+,#/+*%/+ (%M*&+%+[6C+:(+U:8%,&*+--V6+9#+3,#)3b:R+&*(I*232+$*&%/+,#+/%2+/#23*)#%2+%)/%3K%,%2+W+UXZV+P8#&*)+(%/3.)%2+M+ #)+T+717+%20+:*(*+#)+W+N#(%).3*(%26WS+I#)3.)%2+U`[ZVd+[S+,#+#//%2+UCSZV+%:8,3#&*)+I%*+2*2$#:N%+:/0)3:%6+^%2+/#23*)#2+#):*)&%,%2+P8#&*)G+A[+ J.$7.)*N#(%).3*(%2+N#$O3:*2+U11V+UWBZV;+W+,#+#//*2+%0$3:*2+ ^%+@7?"+#2+#/+(D*,*+,#+3(%.#)+(O2+83/3K%,*+$%&%+UAC6[ZV+M+AA+0$3:*2+UYT6SZVd+`+N3$#&$/%23%2+)*,8/%&#2+ #/+#28,3*+N#$O3:*+,3)O(3:*6+H&%:3%2+%/+,#2%&&*//*+,#+P*:%/#2+ U1=FV+ UATZVd+ AA+ %I2:#2*2+ N#$O3:*2+ U>I1V+ /*2+#_83$*2+,#+@7?"+#2+$*23I/#+&#%/3K%&+%).3**(*.&%­UAX6AZV+,#+/*2+:8%/#2+C+UTC6CZV+P8#&*)+#):*)&%,*2+#)+ P0%2;+%)*+%&#&3%/#2+:*(*+Q#)*2%2;+:*)+#Q%/8%:3*)#2+P%2#+%.8,%+M+S+UCT6CZV+#)+P%2#+28I%.8,%+UT+m[S6[Zn+ %&,0%2;+&#:*)2&8::3*)#2+(8/3$/%)%+&3,3(#)23*)%­P8#&*)+2*(#3,*2+%+,&#)%#+$#&:8O)#*+&#$*&O),*2#+ /#2;+3(O.#)#2+#)+(OE3(%+3)#)23,%,+U?-5V+#+3):/82*+28+ *&3.#)+ $3R.#)*Vd+ AW+ :%&:3)*(%2+ N#$%*:#/8/%&#2+ 3(O.#)#2+,#+$#&P823R)+N#$O3:%6+@*,*+#//*+$#&(3#+%/+U717V+ UAY6XZVd+ S+ _832#2+ N#$O3:*2+ 23($/#2+ Ul19V+ (D,3:*+&%,3R/*.*+&#%/3K%&+8)%+%,#:8%,%+:%&%:#&3K%:3R)+U`6[ZVd+ T+ (#O2%232+ j)3:%2+ :*)+ $&3(%&3*+ :*)*:3,*+ ,#+/%+^F1+M+,3P#&#):3%&+/%2+I#)3.)%2+,#+/%2+(%/3.)%2;+US6WZVd+W+3)b/&%:3*)#2+.&%2%2+U[6AZVd+W+1k+U[6AZVd+A+ #Q3%),*+#28,3*2+3))#:#2%&3*2+M+$&*:#,3(3#)*2+3)#&­%(3/*3,*232+UA6CZVd+A+N#(%*(%+28I:%$28/%&+UA6CZVd+ Q#):3*)32%2;+*+I3#)+3),3:%&+#28,3*2+,#+:*($/#(#)*+A+I3/*(%+UA6CZVd+A+%,#)*(%+N#$O3:*+U>1V+UA6CZV+M+A+ M+#Q%/8%:3R)+28I2#:8#)#2+:*(*+/%+&#2*)%):3%+(%.­:32*%,#)*(%+UA6CZV+Ub.8&%+WV6 )D3:%+UJ?V6[ F8#&*)+ 2*(#3,%2+ %+ I3*$23%+ .83%,%+ $*&+ @7?"+ AX+ 9#+N%+83/3K%,*+#/+D&(3)*+,#+o3):3,#)%/*(%2p+$%&%+/#23*)#2+ UWS6CZV+ $%&%+ 28+ ,3%.)R23:*+ ,#b)33Q*d+ ,#+ ,#)*(3)%&+%+%_8#//%2+/#23*)#2+N#$O3:%2+%23)*(O3:%2+#//%2+C+P8#&*)+&#$*&%,%2+:*(*+3),##&(3)%,%2+M+W+:*)+ _8#+2*)+,#2:8I3#&%2+#)+$%:3#)#2+2*(#3,*2+%+%/.j)+,3%.)R23:*+,#+171d+AB+UC`ZV+,#+/%2+/#23*)#2+I3*$23%­ #28,3*+,#+3(%.#)64+a)+)8#2&%+$*I/%:3R)+,#+#28,3*+,%2+P8#&*)+:%&%:#&3K%,%2+$*&+3(%.#)+:*)+$&#:323R)+M+ WY++^1F+UTTZV+P8#&*)+N%//%K.*2+3):3,#)%/#2;+W+,#+#//%2+:*&&#2$*),3#&*)+%/+,3%.)R23:*+N32*$%*/R.3:*6+^%2+TX+ UXZV+(%/3.)%2+M+WS+U`[ZV+I#)3.)%26+"%*2+23(3/%&#2+/#23*)#2+&#2%)#2+UX[ZV+$8,3#&*)+2#&+:%&%:#&3K%,%2+ %+/*2+&#$*&%,*2+$*&+1##$+_8#+(#):3*)%+YAZ+,#+3):3­$*&+@7?"+23)+)#:#23,%,+,#+&#:8&&3&+%+/%+I3*$23%6 ,#)%/*(%2+N#$O3:*2+I#)3.)*2+M+A`Z+(%/3.)*264+5%&%+ ^%+(%M*&0%+,#+/%+/#23*)#2+2#+$&#2#)R+#)+#/+/RI8/*+ (%#&3%/3K%&++/%+:%&%:#&3K%:3R)+$*&+@7?"+,3Q3,3(*2+%+N#$O3:*+,#&#:N*+UTW;+XWZVd+AA+#)+#/+/RI8/*+N#$O3:*+ /%2+^F1+#)+N3$#&Q%2:8/%&#2+#+N3$*Q%2:8/%&#2+U(%/3.­3K_83#&,*+UAXZV+M+X+#)+%(I*2+UAAZV6+9#+3,#)3b:%&*)+ )%2;+I#)3.)%2+*+2#8,*8(*&%/#2V6+a)+)8#2&*+#28,3*+:%/:3b:%:3*)#2+#)+/%2+23.83#)#2+/#23*)#2G+N#(%).3*­ SC6XZ+ ,#+/%2+^F1+P8#&*)+I#)3.)%2+M+[TZ+ (%/3.)%2d+(%2;+717;+l19+M+#)+/%+%(3/*3,*2326+a/+,#&&%(#+$/#8&%/+ #2*+,3b#&#+:*)+/*+&#$*&%,*+$*&+7%&&%2:*2%+#+%/6+#)+M+/%+%2:332+P8#+(O2+:*(j)+#)+/*2+717+M+#)+#/+>16+^%+ WBBSG+WB+$%:3#)#2+:*)+^F1+,#+/%+:8%/#2+2R/*+S+U[BZV+:3&&*232+N#$O3:%;+/%+&*(I*232+$*&%/++M+/%2+P028/%2+%&#­ P8#&*)+I#)3.)%2+M+AT+UXBZV+(%/3.)%26C+a2%+,3P#&#):3%+14 13 1212 1110 9 8 6 6 4 4 2 2 2 1 1 1 1 1 0 F as so a e l a s   a a a r ca s la ca m pl m m om om N si om e su  fo H m no to lo o ni sc en en id si Bi cp ar  u sa gi ci Ab ilo o  Ad ad am as an ar b ra tic su Am oc to ns em  g H pa a  is at on de om H C he ep ci po e  tra at H hi st em fil s  ui In si H Q ta as et ME57#"++KG+=j(#&*+*%/+,#+/#23*)#2+P*:%/#2+N#$O3:%26 Enero­Marzo 2012 49
  5. 5. !7",#/+BBG+7%&%:#&023:%2+,#+/%2+/#23*)#2+*I2#&Q%,%2 ^#23R) = +9#E*+ 1#$%*$%0% Ascitis Derrame 7%ss 9N8)++*iM+@c5 HH A[ M 1 1 W+9N8) 1=F ` M [ 1 AH 11 H S 2 S 717 12 H 11 C ` 2 T+@c5 l19 S M 2 1 1 ?a@ 4 H 1 1 2 -H 2 H HAH 2 H >?- 1 M HEMA 1 M=+t+)j(#&*+*%/+,#+$%:3#)#2d+11+t+N#(%).3*(%+N#$O3:*d+1=F+t+N3$#&$/%23%+)*,8/%&+P*:%/d+>1+t+%I2:#2*+N#$O3:*d+717+t+:%&:3)*(%+N#$%*:#/8/%&d++l91+t+_832#2+23($/#2+N#$O3:*2d++?a@+t+(#O2%232d++-H+t+3)b/&%:3R)+.&%2%d+1>1+t+N%(%&*(%+N#$O3:*d+1a?>+t+N#(%*(%+N#$O3:*d+>?-+t+%(3/*3,*232+N#$O3:%d+k1+t+I3/3*(%+N#$O3:*d+>1+t+%,#)*(%+N#$O3:*d+7-9@+t+:32*%,#)*(%+N#$O3:*d+7%ss+t+:%/:3b:%:3R)d+@c5+t+&*(I*232+Q#)*2%+$*&%/62#+ ,#I#+ %+ /%+ ,##::3R)+ $&#:*K+ M+ /%+ %::#23I3/3,%,+ ,#+ 2%)*+M%+_8#+#2*+$8#,#+23(8/%&+8)%+/#23R)+8(*&%/+*+/*2+(D*,*2+,#+3(%.#);+:*(*+/%+@7?";+_8#+#)#(*2+ (#%2O23:%11+U3(%.#)+AV6N*M+#)+,0%6+a)+/%2+/#23*)#2+N3$#&Q%2:8/%&#2+_8#+&#$*&­ h&%+ /#23R)+ 2#8,*8(*&%/+ P8#+ #/+ N#(%*(%+ 28I­%(*2+2#+3):/8M#+%/+717;+%/+N#(%).3*(%+M+%+/%+1=F+ :%$28/%&+ U3(%.#)+ WV6+>/.8)%2+ /#23*)#2+ $&#2#)%&*)+_8#+P8#&*)+(#*&+:%&%:#&3K%,%2+#)+/%+P%2#+%&#&3%/+,#/+ :%/:3b:%:3*)#2+%2*:3%,%2+:*(*+l19;+N#(%).3*(%2;+#28,3*+,3)O(3:*+$*&+@7?"6+=3)*+#+%/6+%)%/3K%&*)+%+/%2+ + 717+M+%(3/*3,*2326+9*8$32+#+%/6+&#%/3K%&*)+8)%+:*&&#­/#23*)#2+N#$O3:%2+$*&+28+P*&(%+,#+&#%/:#+#)+/%+P%2#+ /%:3R)+M+:%&%:#&3K%:3R)+,#+/%2+:%/:3b:%:3*)#2+N#$O3:%2+%&#&3%/+M+&#$*&%&*)+8)+Q%/*&+$&#,3:3Q*+$*233Q*+,#+YWZ+ M+*I2#&Q%&*)+_8#+/*2+%.#)#2+_8#+(O2+2#+:*&&#/%:3*)%)+M+8)%+#2$#:3b:3,%,+,#+YBZ+#)+/*2+N#(%).3*(%2;+(#­ :*)+#2#+N%//%K.*+P8#&*)+/%2+#)P#&(#,%,#2+,#+*&3.#)+O2%232+M+7176S+h&*2+,%*2+%2*:3%,*2+%/+717+P8#&*)+ 3)e%(%*&3*;+ /*2+ .&%)8/*(%2+ U8I#&:8/*232V;+ #/+ _832#+/%+N#$%*$%0%+$&#Q3%;+P028/%++%&#&3*$*&%/+M+&*(I*232+ por  546%#"4"4478;+ /*2+ N#(%).3*(%2;+ #/+ %,#)*(%+,#+/%+Q#)%+$*&%+:*(*+/*+&#$*&%,*+$*&+?*&3+#+%/6;+_8#+ N#$%*:#/8/%&;+ #/+ 717;+ #/+ :*/%).3*:%&:3)*(%+ M+ /%2+,#(8#2&%)+/%+%2*:3%:3R)+,#+/*2+717+:*)+P028/%+%&#­ (#O2%232;+#2$#:3%/(#)#+$*&+:%&:3)*(%+,#+:*/*)612 &3*$*&%/67  -)%(**+q+#+%/6+%)%/3K%&*)+/%2+3(O.#)#2+,#+ a/+,#&&%(#+$/#8&%/+M+/%+%2:332+2#+%2*:3%&*)+(O2+:*)+@7+#)+C+$%:3#)#2+:*)+717+#):*)&%),*+*I2&8::3R)+ /*2+ %I2:#2*2;+ /%2+ (#O2%232+ M+ #/+ 7176+ 9#.j)+ 2#+,#+/%2+&%(%2+,#+/%+Q#)%+$*&%+$*&+&*(I*2326Y+ a)+/*2+ &#$*&%;+#)+YBZ+,#+/*2+$%:3#)#2+:*)+%2:332+D2%+#2+N#(%).3*(%2+ %0$3:*2+ 2#+ *I2#&QR;+ ,#+ 3.8%/+ (%)#&%;+ 2#:8),%&3%+%+N3$#&#)23R)+$*&%/+$*&+:3&&*232+N#$O3:%d+8)%+ P028/%+ %&#&3*$*&%/6+ kM8)+ rk+ #+ %/6+ #):*)&%&*)+ ABZ+$&#2#)%)+8)+$&*:#2*+(%/3.)*+M+#)+[Z+/%+:%82%+_8#+ )*+ )#:#2%&3%(#)#+ /%+ $&#2#):3%+ ,#+ 8)%+ P028/%+ #2+8)%+3)28b:3#):3%+:%&,0%:%d+#/+XZ+&#2%)#+2#+&#$%&#+%&#&3*$*&%/+2#+%2*:3%I%+:*)+8(*&+(%/3.)*+M%+_8#+2#+ #)&#+(j/3$/#2+$&*:#2*2+(#)*2+P&#:8#)#26A[+@%)*+#/+N%+#):*)&%,*+#)+%2*:3%:3R)+:*)+N#(%).3*(%26` La  (D,3:*+&%,3R/*.*+:*(*+#/+D:)3:*+&%,3R/*.*+,#I#)+#)#&+(%M*&0%+ ,#+ /%2+ /#23*)#2+ N3$*Q%2:8/%&#2+ _8#+ #):*)­ 8)+%($/3*+:*)*:3(3#)*+,#+/*2+$&**:*/*2+,#+@7?";+&%(*2+:*&&#2$*),3#&*)+%+_832#2+N#$O3:*2+23($/#26+ %20+:*(*+/%+3)P*&(%:3R)+:/0)3:%+$#&3)#)#+_8#+$#&(3%+^%2+ /#23*)#2+ 2#8,*8(*&%/#2+ P8#&*)+ &#$&#2#)%,%2+ ,#:3,3&+_83D)+M+_8D+$%&%+8)+%)O/3232+:*&&#:*+,#+/%+$%­$*&+/*2+%I2:#2*2+N#$O3:*2+_8#+P8#&*)+,&#)%,*2+M+28+ */*.0%+N#$O3:%+M+28+^F16+5%&%+#//*;+M+$%&%+8)%+(#*&+*&3.#)+P8#+$3R.#)*+U[S6[ZV+#)+:%)3,%,+:#&:%)%+:*)+ :*($&#23R);+83/3K%(*2+8)%+%I/%+:*)+/%2+:%&%:#&023:%2+/%+$8I/3:%,%+$*&+r#PP&#M+Jk+#+%/6G+*&3.#)+$3R.#)*+#)+ ,#+&#P*&K%(3#)*+,#+/%+^F1+$*&+@7?"+U:8%,&*+---V6[BZ+,#+/*2+%I2:#2*2+,&#)%,*210+M;+#)+2#.8),*+/8.%&;+/%+3)b/&%:3R)+.&%2%6+1%/Q*(2#+>J+#+%/6+&#%/3K%&*)+8)%+ I&./*&.+01/;".$7-"#&.+0&12%$".+9&*5*".:%&%:#&3K%:3R)+$*&+@7?"+,#+/%+3)b/&%:3R)+.&%2%+_8#+ 97%8$)(6)+,$%4"(8%:+*)(;9<=>. a/+l19+2#+3,#)3b:%+&#$&#2#)%+^F1+(%/+,#/3(3%,%;+28I2#.(#)%&3%;+_8#+ #)+ #)&#+ CZ+ M+ XZ+ ,#+ /%+ $*I/%:3R)+ .#)#&%/;14  se  en­)*+ :%82%+ #P#:*+ ,#+ (%2%+ M+ )*+ ,#2$/%K%+ /*2+ Q%2*26+ :8#)&%)+,#+P*&(%+3):3,#)%/+M+(O2+P&#:8#)#(#)#+#)+a/+ $&*I/#(%+ ,3%.)R23:*+ 2#+ $&#2#)%+ :8%),*+ #E32#+ (8#&#26+58#,#+2#&+2*/3%&3*+*+(j/3$/#+M+28+,3O(#&*+Q%­3)b/&%:3R)+.&%2%+:*)+oP*:*2p+,#+$%&D)_83(%+N#$O3:*+ &0%+,#+(3/0(#&*2+N%2%+:#)0(#&*2;+)*+3#)#+$*#):3%/+50 Enero­Marzo 2012
  6. 6. B4"5&*+FG (a)+^#23R)+P*:%/+N#$O3:%+N3$#&,#)2%6+L9M+5#&232#):3%+,#+/%+/#23R)+#)+P%2#+%&#&3%/+23)+_8#+(8#2&#+&#%/:#+:*)+N3­$*,#)23,%,+,#/+$%&D)_83(%+N#$O3:*+$*&+3)b/&%:3R)+.&%2%6+(c)+7*&#+:*&*)%/G+/%+/#23R)+)*+##&:#+#P#:*2+,#+(%2%+M+/*2+Q%2*2+/%+%&%Q3#2%)+#)+&#/%:3R)+:*)+#/+2#8,*8(*&6B4"5&*+KG (a)+^#23R)+28I:%$28/%&+32*,#)2%+%/+$%&D)_83(%+:*)+23.)*+,#/+N#(%*:&3*6+L9M+a)+#/+#28,3*+,3)O(3:*+2#+*I2#&Q%+N3$*Q%2:8/%&6+(c)+a/+8/&%2*)3,*+(*2&R+8)%+/#23R)+%)#:*3:%+:*)+#:*2+3)#&)*26+a28Q*+#)+&#/%:3R)+:*)+#/+N#(%*(%+28I:%$28/%&6(%/3.)*+M+#2+%23)*(O3:*6AC+a2O+&#Q#23,*+,#+8)%+:%$%+ N3$*,#)2*2+#+N3$*Q%2:8/%&#2+#)+*,*+#/+#28,3*+,3)O­2#):3//%+,#+#$3#/3*+:8I*3,%/+M+(#)*2+P&#:8#)#(#)#+ (3:*;A`+ ,#+ :*)*&)*+ $*I&#(#)#+ ,#b)3,*+ M+ $8,3#),*+,#+ #$3#/3*+ #2:%(*2*+ *+ :*/8()%&6AS+ 98+ %2$#:*+ $*&+ %P#:%&+%+%(I*2+/RI8/*2+N#$O3:*220 U3(%.#)+TV6@7?"+#2+#/+,#+8)%+^F1+I3#)+:3&:8)2:&3%;+N3$*,#)2%;+ !%8$"2)#":(@%*%?(;!A>. a/+7k+#2+$*:*+P&#:8#)#G+N*(*.D)#%+#+N3$*Q%2:8/%&+#)+*,*+#/+#28,3*+,3)O(3:*;+ (#)*2+,#+CZ+#2+3)&%N#$O3:*+M+YCZ+#E&%N#$O3:*6+a2+8)+Q%/*&+,#+%#)8%:3R)+$&RE3(*+%/+%.8%+,#+WB+<1+UBf 8)%+/#23R)+,#+:*)#)3,*+/0_83,*;+(8/3/*:8/%&+,#+/#)*+AB+<1Vd+28+$%&#,+.#)#&%/(#)#+)*+(8#2&%+&#%/:#+&%2+ :&#:3(3#)*d20+CCZ+%P#:%+%/+/RI8/*+,#&#:N*+M+W`Z+%/+/%+ %,(3)32&%:3R)+ ,#+ (#,3*+ ,#+ :*)&%2#+ 3)&%Q#)*2*+ /RI8/*+3K_83#&,*d+%+%(I*2+ASZ6+9#+$&#2#)%+#)+(8#&#2+U-cVAC+ U3(%.#)+ [V6+ ^%+ /#23R)+ ,#+ (#)*&+ %(%]*+ $8#,#+ :*)+#,%,+(#,3%+,#+[Y+%]*2+M+2#+N%+:*)23,#&%,*+8)%+(*2&%&+8)%+,#)23,%,+28$#&3*&+%+WB+<1+$*&+8)+#P#:*+,#+ /#23R)+ $&#(%/3.)%+ :*)+ 20)*(%2+ &#/%:3*)%,*2+ :*)+ #/+Q*/8(#)+$%&:3%/+:*)+#/+$%&D)_83(%+N#$O3:*+%,M%:#)#;+ #P#:*+,#+(%2%+_8#+:*),3:3*)%6AX;AY;WB+a/+7k+:*)3#)#+#)+#2$#:3%/+#)+3(O.#)#2+:*)+:*)&%2#6AT;ACfAX 8)%+:%$%+,#+:D/8/%2+2#:&#*&%2+,#+(8:N%2+/0)#%2+$%­ <:?$":8( @%*%?)8( ;<A>( "( 4":+*)B"8( 2)( C"#( &#:3,%2+%+/%+$%&#,+,#+8)+_832#d+28+:*)#)3,*+$8#,#+2#&+D)E)#@7?-. ^*2+1k+P8#&*)+,#2:&3*2+#)+A`AY;+2#+#)­ ,#+3$*+$&*#0)3:*;+(8:3)*2*;+.#/%3)*2*+M+#)+*:%23*)#2+:8#)&%)+,#+(%)#&%+3):3,#)%/+#)+#)&#+B6S+M+C6SZ+,#+ $8&8/#)*+*+N#(*&&O.3:*+:8%),*+2#+#E$*)#+%+8)+&%8­/*2+$%:3#)#2+2*(#3,*2+%+/%$%&**(0%+*+%8*$23%2+M+ (%32(*6AX;AY;WB+a)+/%+@7?"+#/+7k+%$%&#:#+:*(*+8)%+2*)+%23)*(O3:*26AY+^*2+1k+2*)+/#23*)#2+P*:%/#2+:*(­ /#23R)+P*:%/+N#$O3:%+,#+:*)#)3,*+/0_83,*+:*)+%I3_8#2+$8#2%2+,#+#2&8:8&%2+I3/3%&#2+3)&%N#$O3:%2+_8#+2#+ 3)#&)*2;+,3O(#&*+_8#+Q%+,#+A6C+:(+N%2%+[C+:(;+$%&#,+*&3.3)%)+#)+/*2+:*),8:*2+I3/3%&#2+#(I&3*)%&3*2+_8#+)*+ .&8#2%;+ I3#)+ ,#b)3,%+ M+ &%&%(#)#+ :%/:3b:%,%d+ $8#,#+3)Q*/8:3*)%)+M+#2O)+%$3K%,*2+,#+#$3#/3*+_8#+)*+:*(8­ $&#2#)%&+)R,8/*2+(8&%/#2+M+#E:&#:#):3%2+$*/3$*3,#%2;+)3:%+:*)+#/+O&I*/+I3/3%&6A`+a)+/%+@7?"+$8#,#+2#&+j)3:*2+ 23)+#(I%&.*;+#2*+N%+23,*+&#$*&%,*+#)+#/+:32*%,#)*­*+(j/3$/#2;+:*)+%(%]*+(#)*&+%+A6B+:(+,#+,3O(#&*;+ :%&:3)*(%+I3/3%&61 Enero­Marzo 2012 51
  7. 7. !7",#/+BBBG+7%&%:#&023:%2+,#+/%2+/#23*)#2+#)+/%+*(*.&%P0%+:*($8%,%+(8/3,##:*&%52 F)8%"#)8(G"4*)8(6)+,$%48(@)#%-#8( ^#23R) F%2#+23($/# F%2#+%&#&3%/ F%2#+Q#)*2% F%2#+,#+#_83/3I&3* h&%2+:%&%:#&023:%2 1#(%).3*(%+ -2*,#)2%+ J#%/:#+$#&3PD&3:*+M+)*,8/%&+ J#%/:#+:#)&0$#*+ J#%/:#+/3.#&%(#)#+N3$#&,#)2* J#%/:#+23(3/%&+%+/%+%*&% ./*I8/%&+,32:*)3)8*26+ J#%/:#+23(3/%&+%+/%+$*&% +%/+$%&#)_83(%+N#$O3:*++%+/*2+ 9N8)+%&#&3*+$*&%/Enero­Marzo 2012 J#%/:#+23(3/%&++%+/%+%*&% Q%2*2+%I,*(3)%/#2+                                          13$#&$/%23%+ 1*(*.D)#%+ J#%/:#+&O$3,*+23(3/%&+%/+ J#%/:#+:#)&0$#*+3#)#+ -2*,#)23,%,+ J#%/:#+23(3/%&+%+/%+%*&% )*,8/%&+P*:%/+ #+N3$*,#)2% $%&D)_83(%+N#$O3:* :3:%&3K+:#)&%/+N3$*,#)2% ^%+:3:%&3K+2#+N%:#+N3$#&,#)2%+ 9N8)+%&#&3*+$*&%/ +N*(*.D)#*+ Adenoma  Hipodensa o 13$#&,#)2%;+&#%/:# ^#Q#(#)#+ ^#Q#(#)#+N3$*,#)2% 9#+%2*:3%+#)+8)+TBZ+%+N#(*&&%.3% N3$#&,#)2%+ +$#&3PD&3:*;+(#)*2+ N3$*,#)2% UJ#%/:#+,#+/%+:O$28/%V [BZ+$&#2#)%+:%$28/%+N3$*,#)2%+M+ 3),#)2*+M+N##&*.D)#% &#%/:#+#)+P%2#2+%&,0%2 CZ+2#+%2*:3%+:*)+:%/:3b:%:3*)#2 ^1F+:*)+ Hipodensos Hipodensos Hipodensos Hipodensos >#)8%:3R)+23(3/%&+%/+%.8%+WB+<1 %#)8%:3R)+ ^3_83,* F)8%"#)8(G"4*)8(6)+,$%48(:*%-#8 Hepatocarci­ 13$#&Q%2:8/%&+U/#23*)#2+ 13$*,#)2%+*+32*,#)2%+%/+$%&D)­ >).3*.#)#232+8(*&%/+:*)+Q%2*2+ )*(%+U171V Hipodenso  (#)*&#2+,#+[:(V6 13$*,#)2%+*+32*,#)2%+%/+ _83(%+N#$O3:* ,#2*&.%)3K%,*2+,#+.&8#2*+:%/3I&# 13$*Q%2:8/%&+U/#23*)#2+ $%&D)_83(%+N#$O3:* J#%/:#+,#+$2#8,*:%$28/%V >2:3%,*+%+N#(*&&%.3%6 (%M*&#2+,#+[:(V6 U/%Q%,*+&O$3,*+,#/+:*)&%2#V @&*(I*232+8(*&%/+$&*%/++2 J#P8#&K*+:#)&%/+N*(*.D)#*+ J#%/:#+,#+2#8,*:O$28/% 8$&%N#$%3:%2+M+:%Q%+3)P#&3*&+:*) P*:%/+*+(8/3P*:%/+,#+8)+)*,8/* +&#%/:#+23(3/%&+%/+8(*& +*+(%2%+N#$O3:% 732*%,#)*­ Hipodenso J#P8#&K*+:%$28/%&+ 7%/:3b:%:3*)#2++)*,8/%&#2+*+ carcinoma densidad  2#$%/+M+,#+)R,8/*2+ /3)#/%#2 %.8% $%$3/%&#26+J#P8#&K*+,# +282+2#$*2 ?#O2%232+ Hipodensa  Hipondesa 13$*,#)2%+:*)+&#%/:#+,#+28+ 13$*,#)2%6+ >,#)*:%&:3)*(%2+,#/+&%:*+ N3$*,#)2%2 borde de manera  .%2&*3)#23)%/+$O):&#%2+(%(% :*)3)8% +M+I&*):*.#)3:%2 ?#O2%232+ Hiperdensa J#%/:#+,*(3)%)#6 ^%Q%,*+$&#:*K -2*,#)2%+*+N3$*,#)2%+ @8(*&#2+)#8&*#),*:&3)*2;+ N3$#&,#)2%2 J#%/:#+N*(*.D)#* -2*,#)2%+*+N3$*,#)2% sarcomas carcinoma  +#($&%)*+*+P*:*2 ,#+:D/8/%2+&#)%/#2+M+(#/%)*(% +)*,8/%&#2+
  8. 8. B4"5&*+NG (a)+^#23R)+P*:%/+N#$O3:%6+L9+>+$M+13$*Q%2:8/%&+#+N3$*,#)2%+#)+*,*+#/+#28,3*+,3)O(3:*+:*)+,#)23,%,+,#+/0_83,*+#)+&#/%:3R)+:*)+8)+_832#+23($/#+,#/+N0.%,*6B4"5&*+OG (a)++^#23R)+P*:%/+(#)*&+%+A6B+:(6+L9M+7*&#+:*&*)%/6+(c)+"8&%)#+#/+#28,3*+,3)O(3:*+$#&232#+N3$*,#)2%+#)+&#/%:3R)+:*)+#/+N%(%&*(%+N#$O3:*6 H@84)8"(6)+,$%4"(;H@<>. ^*2+%I2:#2*2+N#$O3:*2+2#+ PD&3:*+,#+%/%+%#)8%:3R)+(*2&%),*+#/+8%-#"(2)(2"@*)(:/%23b:%)+,#+%:8#&,*+:*)+28+$%R.#)*+,#+*&3.#)+:*(*G+ dianaAX;AY;WB+U3(%.#)+CV6$3R.#)*2+U5846)?%46%(4"*%(y(A4$)?"%2)8V;+%(#I3%)*2+U5#$:")@(6%8$"*E$%4V+*+(3:R3:*2+U!#2%2(*@%4#8I( I&./*&.+01&#;".$7-"#&.+0&12%$".+9&*5*".H8+)?-%**78 y(!?E+$"4"4478V620+^*2+$%:3#)#2+$8#,#)+ <):#-%":(6)+,$%4"(;<<>.+a/+11+3#)#+8)%+3):3­$#&(%)#:#&+%23)*(O3:*2+*+$&#2#)%&+20),&*(#+P#I&3/;+ ,#):3%+_8#+*2:3/%+#)&#+B6T+M+WBZ+U:3P&%+*I#)3,%+#)+(%/#2%&+ M+ (*/#23%2+ %I,*(3)%/#26+ a/+ %2$#:*+ U#)+ /%+ %8*$23%2V621 5*&+/*+&#.8/%&+#2+%23)*(O3:*+M+2#+#):8#)­@7?"V+,#+8)+>I1+Q%&0%+,#+%:8#&,*+:*)+/%+P%2#+,#+/%+ &%+,#+(%)#&%+3):3,#)%/+#)+$%:3#)#2+#28,3%,*2+:*)+3)P#::3R)G+ #)+ /%+ P%2#+ 28I%.8,%+ #/+ %I2:#2*+ 3#)#+ 8)%+ @7?"+ $*&+ :8%/_83#&+ &%KR)6+ 58#,#+ 2#&+ 3,#)3b:%,*+ %+%$%&3#):3%+N3$*,#)2%;+N3$*Q%2:8/%&;+8)3/*:8/%&+,*),#+ :8%/_83#&+#,%,+M+2#+N%+#23(%,*+_8#+28+3):3,#):3%+Q%&0%+/%+ )#:&*232+ M+ /%+ /3:8#P%::3R)+ $&#,*(3)%)dAX;AY;WB+ #)+ /%+ ,#+XB+%+`CZ+#)+(8#&#2622 98+*&3.#)+)*+N%+23,*+:*($/#­P%2#+ %.8,%+ #/+ %I2:#2*+ :*)+ P&#:8#):3%+ 2#+ (%)3b#2%+ %(#)#+#)#),3,*+$#&*+2#+:*)23,#&%)+(%/P*&(%:3*)#2+:*(*+8)%+/#23R)+N3$*,#)2%+8)3+*+(8/3/*:8/%&6 78%),*+ Q%2:8/%&#2+:*).D)3%2+_8#+:&#:#)+$*&+#:%23%+M+)*+$*&+N%M+(j/3$/#2+%I2:#2*2+%$%&#:#+8)+%:j(8/*+/*:%/+,#+ N3$#&$/%23%+*+N3$#&&*b%6+98+%(%]*+Q%&0%+,#+(3/0(#&*2+/#23*)#2+ :*)*:3,*+ :*(*+ 8%-#"( 2)*( 4&:7*"  o  4*78$)?  %+AB+:(6+a/+11+2#+,3Q3,#)+#)+$J+%4"+UN#(%).3*(%+3$*+(8M+ 3),3:%3Q*+ ,#+ 28+ *&3.#)+ $3R.#)*d+ #/+ .%2+ :#)&%/+ AV+M+$J+%4"+UN#(%).3*(%+3$*+WV6W[+a/+11+%0$3:* *:8&&#+_8#+%$%&#:#+#)+P*&(%+(j/3$/#;+#)+I8&I8%2+*+:*(*+8)+ #)+ WB+ %+ [BZ+ ,#+ /*2+ :%2*2+ M+ 2#+ :%&%:#&3K%+ $*&+ 2#&+)3Q#/+N3,&*%D&#*+#2+3),3:%3Q*+,#+%I2:#2*;+28+$%&#,+#2+ 8)%+/#23R)+(#)*&+%+A+:(;+/*+_8#+:*),3:3*)%+_8#+2#%+$*I&#(#)#+,#b)3,%;+,#+%#)8%:3R)+N*(*.D)#%;+_8#+ 32*,#)2*+#)+P%2#+23($/#;+,#2$8D2+,#+/%+%,(3)32&%:3R)+&#%/K%d+%+(#)8,*+#E32#+8)%+#2&#:N%+K*)%+,#+&%)23:3R)+ ,#/+(#,3*+,#+:*)&%2#+2#+*I2#&Q%+8)+&#%/:#+#E_8323*;+:*)+8)+Q%/*&+,#+%#)8%:3R)+/3.#&%(#)#+(#)*&+#)&#+ 3)(#,3%*;+ )*,8/%&;+ j)3:*;+ 23)+ #/+ //#)%,*+ :#)&0$#*;+/%+K*)%+:#)&%/+,#+I%%+%#)8%:3R)+M+#/+&#I*&,#+$#&3­ $%&%+ N%:#&2#+ 32*,#)2*+ %/+ $%&D)_83(%+ N#$O3:*+ #)+ Enero­Marzo 2012 53
  9. 9. P%2#2+%&,0%2+U3(%.#)+SV6+58#,#+$&#2#)%&+%(I3D)+8)+ N#$O3:*+ :*)+ :%(I3*2+ :3&&R3:*2+ #/+ 11+ ,32(3)8M#+ ,#+//#)%,*+/#)*+*+(8M+/#)*+_8#+)*+//#.%+%+#Q3,#):3%&2#+ %(%]*+Q*/Q3D),*2#+bI&R3:*;+/*+_8#+,3b:8/%+/*2+,3%.­#)+/%2+,3P#&#)#2+P%2#2624  a2+$*23I/#+,#(*2&%&+P028/%+ )R23:*2+&%,3*/R.3:*+M+$%*/R.3:*+23)+_8#+2#+,#2:%&#+%&#&3*$*&%/;+ :%/:3b:%:3R);+ &*(I*232;+ N#(*&&%.3%+ *+ /%+$*23I3/3,%,+,#+/#23R)+(%/3.)%627)3Q#/#2+ /0_83,*f/0_83,*+ 3)&%/#23*)%/624  a/+ 11+ 0$3:*  se  <%+)?+*8%(#"27*?(G"4*(;<KL>. ^%+1=F+#2+/%+2#.8)­$&#2#)%+#)&#+XT+M+YBZ+,#/+*%/+,#+/%2+^F1WC de di­ ,%+^F1+I#)3.)%+(O2+:*(j)+,#2$8D2+,#/+N#(%).3*(%+(#)23R)+3.8%/+*+(#)*&+%+T+:(d+2#+:%&%:#&3K%+#)+P%2#+ M+&#$&#2#)%+YZ+,#+*,*2+/*2+8(*&#2+N#$O3:*26WY+9#+23($/#+$*&+2#&+8)%+^F1+N3$*,#)2%;+:*)+N3$*%#)8%:3R)+ *I2#&Q%+#)+##)&#+W+M+CZ+,#+/%+$*I/%:3R)+,#+:8%/_83#&+23(3/%&+ %+ /%+ ,#+ /*2+ Q%2*2;+ ,#+ :*)*&)*2+ ,#b)3,*2;+ ,#+ #,%,+M+%P#:%+%+%(I*2+2#E*2+:*)+8)%+&#/%:3R)+,#+WGA+/*:%/3K%:3R)+28I:%$28/%&;+%+/%+%,(3)32&%:3R)+,#+(#,3*+ #)+(8#&#2+%,8/%26W`+J%&%+Q#K+#2+23)*(O3:%;+$*&+/*+,#+ :*)&%2#+ #),*Q#)*2*+ (8#2&%+ 8)+ &#P*&K%(3#)*+ .#)#&%/+$8#,#+:&#:#&+(O2+,#+AB+:(+,#+,3O(#&*;+#2+3)(#,3%*;+$#&3PD&3:*;+)*,8/%&;+,32:*)3)8*;+:*)+//#)%,*+ I#)3.)%;+j)3:%+*+(j/3$/#+M+2#+/#+N%+&#/%:3*)%,*+:*)+/%+:#)&0$#*;+:*)+&#P*&K%(3#)*+23(3/%&+%/+%/:%)K%,*+$*&+ 3).#2%+,#+%)3:*):#$3Q*2+*&%/#26[B+Aparece en pacien­/%+%*&%+N%:3D),*2#+32*,#)2*+%/+$%&D)_83(%+N#$O3:*+ #2+ 23)+ #)P#&(#,%,+ N#$O3:%+ ,3P82%d[B  se  caracteriza #)+P%2#2+%&,0%221+U3(%.#)+XV6 a/+6):#-%":(-%-#$)  $*&+ 8)%+ $&*/3P#&%:3R)+ ,#+ N#$%*:3*2+ $&*I%I/#(#)#+UN#(%).3*(%+3$*+[+*+.3.%)#V #2+8)%+/#23R)+,#+(%M*&+ 2#:8),%&3%+ %+ 8)%+ (%/P*&(%:3R)+ Q%2:8/%&+ 28IM%:#)­%(%]*+US+%+AB+:(V+_8#+$8#,#)+(*2&%&+O&#%2+:#)&%/#2+ #6WYf[A++^%+1=F+#2+8)%+^F1+b&(#;+)*+#):%$28/%,%;+,#+P*&(%,%2+$*&+:3:%&3:#2+bI&*2%2+_8#+)*+&#%/K%)6WS La  /*2+ N#$%*:3*2+ )*&(%/#2;+ :*)+ 8)%+ :3:%&3K+ :#)&%/+ *+$&#2#)%:3R)+,#/+11+#)+#/+N0.%,*+.&%2*+$8#,#+$&#2#)­ #E:D)&3:%+_8#+)*+#2+Q#&,%,#&%+23)*+_8#+&#$&#2#)%+%&+%/#&%:3R)+#)+28+$%&R)+,#+&#%/:#;+$8,3#),*+#2%&+ 8)+:*)./*(#&%,*+,#+Q%2*2+2%).80)#*26+>,#(O2;+N%M+3)Q#&3,*;+#2+,#:3&G+Q#&2#+N3$#&,#)2*6+a)+#/+$%&D)_83(%+ %I3_8#2+bI&*2*2+,#/.%,*2+_8#+:*)3#)#)+:D/8/%2+,#+B4"5&*+PG (a)+^#23R)+P*:%/+j)3:%+N3$*,#)2%+#)+P%2#+23($/#6+L9M+a)+P%2#+%&#&3%/+$&#2#)%+8)+&#%/:#+$#&3PD&3:*+M+,#+282+2#$*2+,O),*/#+%2$#:*+(8/3/*:8/%,*+U23.)*+,#/+%:j(8/*+*+4*78$)?d+:3&:8/*+,32:*)3)8*V6+(c)+hI2D&Q#2#+#/+&#%/:#+#)8#+,#+28+$%&#,6B4"5&*+QG (a)+^#23R)+32*,#)2%+%/+$%&D)_83(%;+3($#&:#$3I/#6+L9M+a)+#/+#28,3*+,3)O(3:*+$&#2#)%+8)+&#%/:#+23(3/%&+%+/%+%*&%+U:3&:8/*+,32:*)3)8*V6 (c)+a)+P%2#+Q#)*2%+$&#2#)%+,32(3)8:3R)+,#+28+,#)23,%,+#)+&#/%:3R)+:*)+8)+N#(%).3*(%+%0$3:*654 Enero­Marzo 2012
  10. 10. q8$PP#&+M+:*),8:*2+I3/3%&#2+$&3(33Q*2d+#2+3&&3.%,%+$*&+ H2)#":( 6)+,$%4"( ;H<>.  a/+ >1+ 2#+ 3,#)3P3:R+ #)+#/+232#(%+%&#&3%/+N#$O3:*+M+/%+:%/:3b:%:3R)+3)&%(8&%/;++ A`SB;+%]*+#)+_8#+2#+3)&*,8#&*)+/*2+%)3:*):#$3Q*2+/%+.&%2%;+/%+N#(*&&%.3%+M+/%+)#:&*232+3)&%/#23*)%/+2*)+ *&%/#26W[+>j)+)*+2#+2%I#+#/+(#:%)32(*+$&#:32*+$*&+#/+#E&#(%,%(#)#+&%&%26 ^%+Q%&3%)#+#/%).3#:O23:%+2#+ _8#+#/+82*+,#+#2&R.#)*2+*+%),&R.#)*2+$&*Q*:%)+>1;+:%&%:#&3K%+$*&+#)#&+8)%+(%M*&+Q%2:8/%&3K%:3R);+2#&+ 23)+#(I%&.*+2#+&#/%:3*)%+%)*+:*)+/%+,*232+:*(*+:*)+,#+(#)*&+%(%]*+_8#+#/+11+:/O23:*+M+%2*:3%&2#+:*)+ /%+,8&%:3R)620 +a/+>1+$8#,#+2#&+2*/3%&3*+#)+#)&#+XB+M+1=F+(j/3$/#26WYf[A YBZ+,#+/*2+:%2*2d+23)+#(I%&.*;+)*+#2+&%&*+#):*)&%&+ 5*&+@7?"+/%+1=F+2#+,#2:8I&#+,#+(%)#&%+:%28%/;+ W;+[+*+(O2+,#+AB+%,#)*(%2+#)+8)+$%:3#)#;+#)3,%,+#2+28I:%$28/%&+M+$8#,#+#2%&+$#,8):8/%,%6+a)+/%+P%2#+ :*)*:3,%+:*(*+%,#)*(%*2326+a/+>1+2#+N%+%2*:3%,*+23($/#+%$%&#:#+:*(*+8)+8(*&+N*(*.D)#*;+N3$*,#)­ :*)+/%+#)P#&(#,%,+$*&+%/(%:#)%(3#)*+,#+./8:R.#)*+2*+*+32*,#)2*;+3#)#++8)%+:3:%&3K+:#)&%/+*+#E:D)&3:%+ 3$*+ A+ U$8,3#),*+ + $&#2#)%&+ ,#.#)#&%:3R)+ (%/3.)%V6+N3$*,#)2%;+ #)+ /%+ P%2#+ %&#&3%/+ 2#+ *I2#&Q%+ 8)+ &#%/:#+ 78%),*+2#+$&#2#)%+,#+(%)#&%+3),3Q3,8%/+(3,#+,#2,#+#E_8323*+ ,#+ /%+ /#23R);+ 3):/82*+ N*(*.D)#*+ #)+ :%2*+ A+N%2%+(O2+,#+AC+:(d+#2+23)*(O3:*+%+$%&3&+,#+/*2+,#+ _8#+ )*+ N%M%+ :3:%&3K+ :#)&%/+ *+ %I3_8#2+ bI&*2*26+ C+:(6+^%+(%)3P#2%:3R)+:/0)3:%+:/O23:%+,#/+>1+2#+$&#­a)+ /%+ /#23R)+ (%M*&+ 2#+ $8#,#)+ 3,#)3b:%&+ 8)%+ *+ (O2+ 2#)%+%)#+/%+&8$8&%+#2$*)O)#%+*+N#(*&&%.3%;+,%),*+%&#&3%2+)8&3:3%2+N#$O3:%2+.&%),#2;+2#$%/#2;+$#_8#­ /8.%&+ %+ ,*/*&+ %I,*(3)%/+ %.8,*+ M+ %+ /%+ 28I23.83#)#+]%2;+:#)&%/#2+M+Q#)%2+,#+,&#)%#+$&#:*K6+a)+/%+P%2#+ N3$*#)23R)+#+3):/82*+/%+(8#&#6+132*/R.3:%(#)#+/*2+$%&#)_83(%*2%+N#$O3:%+/%+1=F+2#+Q8#/Q#+32*,#)2%+ >1+2#+$&#2#)%)+:*(*+$/%:%2+,#+:*&,*)#2+,#+:D/8/%2+#)+:*($%&%:3R)+:*)+#/+$%&D)_83(%+N#$O3:*+)*&(%/+M;+ $%&#:3,%2+%+/*2+N#$%*:3*2+2#$%&%,%2+$*&+23)82*3,#2+#)+ *:%23*)#2;+ 2#+ $8#,#+ *I2#&Q%&+ 8)%+ 2#8,*:O$28/%+ ,3/%%,*2+3&&3.%,*2+$&3):3$%/(#)#+$*&+%&#&3%2+M+:%&#:#)+_8#+&#$&#2#)%+/%+:*($&#23R)+,#+#3,*+%,M%:#)#+_8#+ ,#+8)%+P8#)#+$*&%/6+a2+$*23I/#+3,#)3b:%&+8)%+:%$28/%+$&*,8:#+/%+/#23R)6 ^%+:3:%&3K+bI&*2%+#E32#)#+$#&(%­ :*($/#%+*+3):*($/#%+M+#//*+$#&(3#+/%+#E#)23R)+,#+/%+)#:#+$*&+/*+.#)#&%/+N3$*,#)2%+#)+/%+P%2#+%&#&3%/+$#&*+ N#(*&&%.3%+N%:3%+/%+:%Q3,%,+%I,*(3)%/6++^%2+:D/8/%2+%(I3D)+$8#,#+&#%/K%&6+a)+/%+P%2#+%&,0%+$8#,#+N%I#&+ ,#+q8$PP#&+2#+#):8#)&%)+#)+)j(#&*+&#,8:3,*+M+:*)+&#%/:#+ ,#I3,*+ %+ /%+ $&#2#):3%+ ,#+ 8)+ %I8),%)#+ #3,*+ $*:%+*+)3).8)%+P8):3R)d+)*+#E32#)+:*),8:*2+I3/3%&#2+(3E*3,#WYf[A+U3(%.#)+YV6 M+#2*+/*+N%:#+N32*/R.3:%(#)#+,3P#&#)#+%+/%+1=F;+/*2+B4"5&*+RG (a)+^#23R)+P*:%/+N#$O3:%+j)3:%+N3$*,#)2%+#)+P%2#+23($/#6+L9M+a)+P%2#+%&#&3%/+$&#2#)%+8)+&#%/:#+)*,8/%&+,32:*)3)8*6+(c)+a)+P%2#+Q#)*2%+$&#2#)%+//#)%,*+:#)&0$#*6+(d)+J#:*)2&8::3R)+#)+["+,#/+N#(%).3*(%+0$3:*+,*),#+2#+#Q3,#):3%+/%+P028/%6B4"5&*+SG (a)+^#23R)+P*:%/+N#$O3:%+:%23+32*,#)2%+%/+$%&D)_83(%6+L9M+J#%/:#+N3$#&Q%2:8/%&+,#+/%+/#23R)+#)+P%2#+%&#&3%/;+N*(*.D)#*+:*)+:3:%&3K+:#)&%/+N3$*,#)2%6+(c)+a)+P%2#2+%&,0%2+2#+*&)%+32*,#)2%+%/+$%&D)_83(%+N#$O3:*+#)+&#/%:3R)+:*)+N3$#&$/%23%+)*,8/%&+P*:%/6 Enero­Marzo 2012 55
  11. 11. 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  13. 13. WS6++q%(#/+ -J;+ ^%g/#&+ ^5+ M+ F32N(%)+ aq6+ [B6++9N%w#,+hq;+J%#),#&+vJ6+>$$&*%:N+*+ [T6++q3(+ 17;+ q3(+ @q;+ 98).+ kq;+ v**)+ 1q;+ 7*($&#N#)23Q#+ %)%/M232+ *P+ NM$#&­ %+ /3Q#&+ (%226+ 7/3)3:2+ 3)+ ^3Q#&+ "32#%2#6+ q3(+ 5=;+ 1%+ 1q+ #+ %/6+ + 7@+ ,8&3).+ N#­ Q%2:8/%&+ /3Q#&+ /#23*)2+ 823).+ ASf?"7@+ WBB`dA[GA`TfWAB6 $%3:+ %&#&3*.&%$NM+ %),+ $*&*.&%$NMG+ %),+ %,Q%):#,+ 3(%.#+ $&*:#223).6+>rJ+ [A6++7%&/2*)+ 9q;+ r*N)2*)+ 7"6+ k#),#&+ 7a;+ >)+ -//82&%3Q#+ &#Q3#g6+ J%,3*.&%$N3:2+ WBBTdAY[GTT[6TCW6 u#/:N+@r6+7@+*P+P*:%/+)*,8/%&+NM$#&$/%­ WBBWdWWGABTAfABCA6WX6++H3II2+rF;+^3g3)+>?+M+q%N/#)I#&.+?96+ 23%+*P+N#+/3Q#&6++>rJ+WBBBdAXTGXBCfXAW6 [C6++5%/%:3*2+ a;+ 9N%))*)+ ?;+ 9*/*(*)+ 7;+ 7*)#($*&%&M+ (%)%.#(#)+ *P+ I#­ [W6++k%&*)+ J^+ M+ 5##&2*)+ ?96+ F&*(+ N#+ H8K(%)+?6++k3/3%&M+:M2%,#)*(%G+</&%­ )3.)+ /3Q#&+ 8(*&26+ 98&.+ 7/3)+ =*&N+>(+ J9=>+ &#P&#2N#&+ :*8&2#26+ 9:&##)3).+ 2*8),;+7@;+%),+?J-6+H%2&*3)#2+J%,3*/+ WBBTdYTGTS[fTYB6 N#+ :3&&N*3:+ /3Q#&+ P*&+ N#$%*:#//8/%&+ A``BdACG[A[f[AS6WY6++k8&.*2+9r;+93/Q%+>r;+^*2%,%+?1;+?%)­ :%&:3)*(%+ g3N+ 7@+ %),+ ?J+ 3(%.3).G+ [S6++^##+ur;+^3(+1q;+r%).+q?;+q3(+91;+^##+ #&*/%+ 7";+ H8K(%)+ H56+ + 13$#&$/%23%+ h$$*&8)33#2+%),+$3P%//26+J%,3*.&%$N3:2+ 9r;+^3(+r1+#+%/6+J%,3*/*.3:+2$#:&8(+*P+ )*,8/%&+P*:%/6+J#Q+7N3/+73&+WBABdSWGABYf WBBAdWAG9AAXf9A[W6 :N*/%).3*:%&:3)*(%G+a($N%232+*)+8)828%/+ AAB6 [[6++k8#*g+57;+?3,w3PP+Jk6+5&3(%&M+(%/3.­ (%)3P#2%3*)2+%),+,3PP#&#)3%/+,3%.)*2#26+W`6++q8(%&+c;+>II%2+>+M+F%82*+=6+?%)8%/+ )%)+)#*$/%2(2+3)+N#+%,8/6+?%.)+J#­ J%,3*.&%$N3:2+WBBAdWAG9`Xf9AAS6 ,#+ $%*/*.0%+ #2&8:8&%/+ M+ P8):3*)%/;+ 2*)+-(%.3).+7/3)+=+>(+A``XdCGWY`f[AY6 [X6++5*g#&2+7;+J*2+5J;+9*8$32+7;+u+q+r*N)2*)+ J*II3)2+y+7*&%)6+S%+#,6+?:+H&%gf13//+ uq;+ 9#.#/+ q16+ 5&3(%&M+ /3Q#&+ )#*$/%2(2G+ 3)#&%(#&3:%)%+A```GW[dT`XfT``6+ ?J+ 3(%.3).+ g3N+ $%N*/*.3:+ :*&&#/%3*)6+ J%,3*.&%$N3:2+A``TdATGTC`fTYW658 Enero­Marzo 2012

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CARACTERIZACION DE LESIONES FOCALES HEPATICAS POR TOMOGRAFIA COMPUTADA MULTIDETECTORES

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