Refresher Courses are recorded courses captured at past RSNA Annual Meetings. Most courses include an audio-visual presentation, as well as a corresponding transcript. The online Refresher Courses are free to members.

Content Areas (Codes):
The following Content Areas will be printed on the certificate for this course:

• Gastrointestinal Radiology
• Ultrasound

Course Learning Objectives:

• Describe the normal anatomy and anatomic variants of the hepatic vasculature.
• Identify the normal Doppler flow profiles of the hepatic vasculature.
• Review the hemodynamic principles of portal hypertension and how they impact the Doppler waveforms of the hepatic arteries, portal veins and hepatic veins.
• Explain the role of ultrasound in the evaluation of variceal pathways.
• Indicate when to use contrast enhanced ultrasound (CEUS) in focal liver diseases.
• Discuss kinetics of US contrast agents.
• Define the importance of the three contrast phases, how CEUS performs in detecting and characterizing focal liver lesions.
• Discuss the potential value as well as the limitations of CEUS in liver disease.
• Explain how CEUS performs when compared to B-mode, color Doppler, CT and MRT imaging.
• Summarize the concept of liver fibrosis grading and the implications for healthcare management.
• Discuss the basis for the assessment of liver fibrosis using elastography, with emphasis on the different techniques.
• Explain the differences in the techniques and the variability in measurement assessment.
• Describe the need and position of this technique in clinical care.

This enduring material is estimated to take 1 hour and 30 minutes to complete.

Online Course Start Date: 12/12/2017
End Date for CME Eligibility/Online Expiration Date: 12/11/2020

This educational activity was originally presented at the RSNA 2016 Annual Meeting and Scientific Assembly.

Authors:

• Myron A. Pozniak, MD
• Hans-Peter Weskott, MD
• Paul S. Sidhu, MRCP, FRCR

Disclosure Statements:
The ACCME requires that the RSNA, as an accredited provider of CME, disclose the relevant financial relationships of the planners, faculty, and any other individuals in a position to control content of this activity. If there is a relevant financial relationship that has been disclosed please find it below:

• Suhny Abbara, MD: Author, Reed Elsevier; Editor, Reed Elsevier; Institutional Research Agreement, Koninklijke Philips NV, Siemens AG.
• David A. Bluemke, MD, PhD: Research support, Siemens AG.
• William W. Boonn, MD: Founder, Montage Healthcare Solutions, Inc; President, Montage Healthcare Solutions, Inc; Shareholder, Montage Healthcare Solutions, Inc, Nuance Communications, Inc.
• Kristy K. Brock, PhD: License agreement, RaySearch Laboratories AB; Development agreement, Varian Medical Systems, Inc.
• Dorothy I. Bulas, MD: Editor, Wolters Kluwer NV.
• Dominik Fleischmann, MD: Research support, Siemens AG.
• Brian S. Funaki, MD: Data Safety Monitoring Board, Novate Medical Ltd.
• Jean-Francois H. Geschwind, MD: Consultant, BTG International Ltd, Bayer AG, Guerbet SA, Sterigenics International, LLC, Koninklijke Philips NV, Jennerex Biotherapeutics, Inc; Grant, BTG International Ltd, Bayer AG, Koninklijke Philips NV, Sterigenics International LLC, Threshold Pharmaceuticals, Inc, Guerbet SA; Founder and CEO, PreScience Labs, LLC.
• Christopher P. Hess, MD, PhD: Research Grant, General Electric Company, Quest Diagnostics Incorporated, Cerebrotech Medical Systems, Inc; Speaker, Siemens AG.
• Vincent B. Ho, MD, MBA: In-kind support, General Electric Company.
• Herbert Y. Kressel, MD: Stockholder, Pfizer Inc, GlaxoSmithKline plc.
• Cherie M. Kuzmiak, DO: Research Grant, FUJIFILM Holdings Corporation.
• Simon S. Lo, MD: Research support, Elekta AB; Travel support, Accuray Incorporated; Speaker, Accuray Incorporated.
• H. Page McAdams, MD: Research Grant, General Electric Company; Consultant, MedQIA Imaging Core Laboratory; Author, Reed Elsevier; Author, UpToDate, Inc; Research Consultant, F. Hoffmann-La Roche Ltd, Boehringer-Ingelheim GmbH.
• Charles E. Ray Jr., MD, PhD: Data Safety Monitoring Board, Novate Medical Ltd; Editor, Thieme Medical Publishers, Inc; Consultant, W. L. Gore & Associates, Inc, Medtronic plc.
• Ehsan Samei, PhD: Research Grant, General Electric Company; Research Grant, Siemens AG.
• Stuart G. Silverman, MD: Author, Wolters Kluwer nv.
• Christina I. Tsien, MD: Speaker, Merck & Co, Inc.
• William J. Weadock, MD: Owner, Weadock Software, LLC.
• Charles E. Willis, PhD: Medical Advisory Board, General Electric Company.
• Myron A. Pozniak, MD: Stockholder, Cellectar Biosciences, Inc; Support, General Electric Company.
• Hans-Peter Weskott, MD: Speaker, General Electric Company, Bracco Group.
• Paul S. Sidhu, MRCP, FRCR: Speaker, Koninklijke Philips NV, Bracco Group, Hitachi, Ltd, Siemens AG.

All other individuals in control of content have indicated that they have no relevant financial relationships to disclose for this activity.

Accreditation and Designation Statements:
The Radiological Society of North America (RSNA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This enduring material can be applied towards the ABR MOC self-assessment requirement (SA-CME).

To earn CME credit, participants must correctly answer a minimum of 80% of the post-test questions and complete the course evaluation.

The RSNA designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Price:
Non-member Rate: $50.00
Member Rate: $0.00

Refund / Exchange Policy:
RSNA will not issue any refunds or exchanges for online only versions of educational products or activities purchased online. Please review the entire product or activity description prior to purchase.

RSNA Disclaimer:
The opinions or views expressed in this activity are those of the presenters and do not necessarily reflect the opinions, recommendations or endorsement of the RSNA. Participants should critically appraise the information presented and are encouraged to consult appropriate resources for information surrounding any product or device mentioned. Information presented, as well as publications, technologies, products and/or services discussed, are intended to inform the learner about the knowledge, techniques, and experiences of RSNA faculty who are willing to share such information with colleagues. The RSNA disclaims any and all liability for damages to any individual user for all claims which may result from the use of said information, publications, technologies, products and/or services, and events.