Liver lesions are groups of abnormal cells in your liver. It is mainly diagnosed according to the definition of liver blood vessels and the degree of ultrasonic attenuation. Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Hepatic attenuation on unenhanced CT (expressed as Hounsfield units) depends on a combination of factors but is most influenced by the accumulation of intracellular vacuoles of triglycerides (i.e., hepatic steatosis) [1]. Is it possible for a lesion in liver to grow from app 1 cm to 2 cm in about 1-1/2 months? Not a death sentence But a failing liver isnt a death sentence. The value of attenuation in normal liver was estimated as 0.52 +/- 0.03 dB/cm/MHz, measured at 3 MHz. Hepatic attenuation on unenhanced CT (expressed as Hounsfield units) depends on a combination of factors but is most influenced by the accumulation of intracellular vacuoles of triglycerides (i.e., hepatic steatosis) [1]. This can be due to a number of things ranging from technical difficulties with the machine to different abnormalities of the liver. If you are a Mayo Clinic patient, this could
And even when it does, it's most often simply a finding of note, but not of consequence. 56 to 65 years. I have no idea what to do? Call your doctor or 911 if you think you may have a medical emergency. Mayo Clinic does not endorse companies or products. The falciform ligament sort of divides parts of the liver, and it's possible even that some of what is being seen is artifactual, meaning just some shadowing due to the crossing of the planes. Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. Materials and methods: We retrospectively correlated the low-attenuation changes of liver grafts which were defined as readings below 50 HU on unenhanced CT with histological findings obtained by needle biopsy or . Low attenuation liver lesions refer to less intense liver lesions that are difficult to distinguish and diagnose in liver imaging tests such as liver CT (computed Tomography, PET (Positron Emission Tomography) scan. Liver adenoma, a rare liver tumor. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Mayo Medical Laboratories. You may feel a quick pain as the needle is inserted into your arm and experience some short-term discomfort at the site after the needle is removed. Here is a brief list: Obesity Diabetes Chemicals and drugs (such as alcohol, corticosteroids, tetracyclines, valproic acid, methotrexate, carbon tetrachloride, and yellow phosphorus) Malnutrition and a diet that is deficient in protein Pregnancy American Liver Foundation. The cookie is used to store the user consent for the cookies in the category "Other. I am assuming it is healthy and normal to have possible focal fatty infiltrate of the liver when liver function blood tests come back normal. , which are benign, however your Dr can best determine if other risk factors or findings (cirrhosis, Dr. Frank Kuitems and another doctor agree. The grades are assigned as follows: S0, no steatosis (0%10% fat; 0237 dB/m); S1, mild steatosis (11%33% fat; 238259 dB/m); S2, moderate steatosis (34%66% fat; 260292 dB/m); and S3, severe steatosis (>67% fat; 293 dB/m). Uniform attenuation in liver. The needle is attached to a small tube, to collect your blood. I am also wondering if you can have decreased attenuation and not have fatty infiltration. Treatments for liver cancer include: Its difficult to prevent benign liver lesions. Fatty liver is a common imaging finding, with a prevalence of 15%95%, depending on the population. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. What does Hypoattenuation mean? Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. What is Meant by Low Attenuation Liver Lesion? Liver function tests check the levels of certain enzymes and proteins in your blood. Hepatomegaly is having an enlarged liver. In the majority of patients, a proper diagnosis can be made based on the characteristics on imaging modalities (Lesions size < 1.0 cm are usually benign). In . According to Dr. West at Cancer Grace, a low-attenuation lesion is a spot that appears on a radiographic image as less dense than the surrounding healthy tissue in that specific organ of the body. Most people don't have serious reactions to having blood drawn. In severe cases of fatty liver, intrahepatic vessels may appear hyperattenuated relative to the fat-containing liver tissue (,17). Accessed April 12, 2021. https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/8452. I have a low attenuation liver lesion more than 5mm. These cookies ensure basic functionalities and security features of the website, anonymously. https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/8677. I also had a 1cm cyst on kidney. 9. Accessed April 12, 2021. Methods used for liver evaluation. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. What does it mean if my pet-ct scan revealed numerous low-attenuation lesions in the liver that are of fluid density consistent with cysts? information is beneficial, we may combine your email and website usage information with
2. , Flush out with plenty of water intake: Water is the best flushing agent. They only thing that was abnormal was my amylase. It was 118 and high limit was 100. What does that mean. Diffuse disease occurs as the hepatocytes are damaged and liver function decreases. Your email address will not be published. Liver surface nodularity has been attributed to re-generative nodules [3]. PT. concluded that finding a small, hypodense lesion in the liver in a patient with otherwise no definite metastases was a benign finding. what does liver attenuation mean. What can cause attenuation? We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Approach to the patient with abnormal liver biochemical and function tests. American journal of roentgenology. These are common, not worth worrying about. My doctor said that where I don't have an alcohol problem or high cholestorol that the decreased attenuation was of no concern. What are low attenuation lesions in the liver? Do I have liver cancer? Aetiology Diffusely increased attenuation iron deposition haemosiderosis thalassaemia haemochromatosis: one paper suggests investigation for iron overload if unenhanced liver density is >75 HU 9 copper deposition Ct w/contrast. For these, please consult a doctor (virtually or in person). A person can remain asymptomatic for years, although 57% of those with the condition will develop symptoms every year. What does low attenuation in the liver mean? 1. Cirrhosis. In addition . If this is the case, your liver should be alright. And if imaging studies show signs of a liver lesion, remember that it might not be serious. You are here: Home. If the radiologist says it's of no significance, I'd say you can feel comfortable that it's of no significance. If youre overweight or obese, reduce the number of calories you eat each day and increase your physical activity in order to lose weight. This results in a scale running from -1000 HU for air . It does not store any personal data. Your doctor will explain your results and what they mean. Some common liver function tests include: There is a problem with
What does it mean if my pet-ct scan revealed numerous low-attenuation lesions in the liver that are of fluid density consistent with cysts? This content does not have an English version. Fatty liver disease means you have extra fat in your liver. Save my name, email, and website in this browser for the next time I comment. Visualized portions of the liver are homogeneous in echogenicity. By using our website, you consent to our use of cookies. Get answers from Diagnostic Radiologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. What causes liver attenuation? Liver lesions are also known as liver tumours which abnormal masses of cells or tissue in the liver. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. Scattered low attenuation hepatic lesions, incompletely Liver attenuation index (LAI) was derived and defined as the difference between mean hepatic and mean splenic attenuation. It is situated in the epigastric, and left hypochondriac regions of the abdomen. In a liver ultrasound examination is a reversible condition what does liver attenuation mean can be isolated and call. The density of the tissue is in proportion to the attenuation of the x-rays which pass through. information and will only use or disclose that information as set forth in our notice of
What is the shape of C Indologenes bacteria? What is normal attenuation in liver? It has also been shown to be less accurate in detecting mild steatosis compared with more advanced steatosis. For these, please consult a doctor (virtually or in person). But opting out of some of these cookies may affect your browsing experience. AJR Am J Roentgenol. It happens when fat builds up in the liver. Mayo Medical Laboratories. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Yellowish skin and whites of the eyes (jaundice). in pet scan, they say it is ametabolic, is it cause for worry? MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. What do the C cells of the thyroid secrete? What are the differences between a male and a hermaphrodite C. elegans? Low attenuation liver lesions refer to less intense liver lesions that are difficult to distinguish and diagnose in liver imaging tests such as liver CT (computed Tomography, PET (Positron Emission Tomography) scan. I am 62 year old male. Colon, lung, breast, and gastric cancers are the most common causes of hypovascular liver metastases. I had a MRI done that showed, the nonspecific fatty infiltrate of the left rectus muscle (again) , this time in addition: "fluid-fluid" level within the gallbladder, either gallbladder sludge or gallstones, slightly thickened posterior fundal gastric wall, and rib pathology is a consideration? will determine what is necessary for visualizing what they are looking for I would go with what they suggest. What does this mean? Lipase elevated 400 dr didnt seemed concerned but I am scared. The appearance of tissues on a CT scan is described in terms of density. can significantly reduce the risk of developing liver lesions. Your doctor may order a combination of tests to diagnose your liver lesions. Its very rare in the U.S. Benign liver lesions usually dont cause any symptoms. https://www.nhlbi.nih.gov/health-topics/blood-tests. Those folks tend to error on the side of being alarmist, not the other way around. Kodama Y, Ng CS, Wu TT et-al. It should be noted that normal transaminase does not mean that fatty liver is not harmful to the body. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. A poor liver function can cause weight gain, especially around the belly. sea-level). Some are noncancerous (benign), and others are cancerous. 3. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. I saw a family doctor recently and had many blood test ran. J. Cardiol. 2000;174 (5): 1417-21. However, you may visit "Cookie Settings" to provide a controlled consent. Causes of liver damage and failure. This website uses cookies to improve your experience while you navigate through the website. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Radiology. Can you still play Colossal Cave Adventure? If only the amalyse is elevated - I assume then the other liver function tests were normal (AST, ALT, Bilirubin, Albumin, GGT). Review/update the
Recommend further evaluation with liver MRI non-emergently. Mayo Medical Laboratories. As a result of this activity, a good liver health is important to maintain stay fit and healthy. Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. Liver cancers always need treatment. This cookie is set by GDPR Cookie Consent plugin. Uncategorized. Hepatic attenuation on CT. Reference article, Radiopaedia.org (Accessed on 01 Mar 2023) https://doi.org/10.53347/rID-8020, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":8020,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/hepatic-attenuation-on-ct/questions/2005?lang=us"}. Many people only find out they have one when they go for an imaging test, like an ultrasound, for a different health issue. The value of attenuation in normal liver was estimated as 0.52 +/- 0.03 dB/cm/MHz, measured at 3 MHz. liver amyloidosis), acute hepatitis, or acute liver failure [6], [7]. Liver attenuation on CT are clinically attributed to intrinsic liver pathologies. We use cookies to ensure that we give you the best experience on our website. Which is an example of a low attenuation lesion? Anyhow, the family doctor said that the decreased attenuation area was very normal and of no concern since I don't have alcohol or cholestorol problems. Khalil et al. Levels that are higher or lower than normal can indicate liver problems. If benign liver lesions are large and cause symptoms, they can be removed by surgery. Your blood will be sent to a laboratory for analysis. Liver lesions are abnormal growths that have various causes. Transient hepatic attenuation differences are thought to be due to a localized mismatch in hepatic arterial versus portal venous blood supply, where often there is a relative increase in hepatic arterial supply thereby giving a higher attenuation to the affected region. LAI greater than 5 HU correlated with macrovesicular steatosis of <5%. Low attenuation liver lesions refer to less intense liver lesions that are difficult to distinguish and diagnose in liver imaging tests such as liver CT (computed Tomography, PET (Positron Emission Tomography) scan. Care was taken to sample homogeneous areas representative of the parenchyma, with avoidance of vessels, bile ducts, focal lesions . To determine whether it affects liver function, blood tests to evaluate liver function would have to be performed. Etiology Diffusely increased attenuation iron deposition hemosiderosis thalassemia hemochromatosis: one paper suggests investigation for iron overload if unenhanced liver density is >75 HU 9 copper deposition (I did use to bing drink quite often in high school and colledge, but now only have 1-4 alcoholic drinks a week. Fatty change can definitely cause that to happen. health information, we will treat all of that information as protected health
The report did say this, " decreased attenuation next the the falciform ligament which is believed to represent area of focal fatty infiltration and is of no clinical significance". evaluated without intravenous contrast, for example in the right hepatic does this mean i have cancer. The LAI between -10 and 5 HU correlated well with macrovesicular steatosis in the mild-to-moderate range of 6%30%. Accessed April 12, 2021. When do you find out you have liver lesions? What is normal attenuation in liver? So you are saying that decreased attenuation usually means that there has been fatty infiltraton. The diagnostic standard of reference is biopsy with histologic analysis, but fat deposition in the liver may be diagnosed noninvasively with US, CT, or MR imaging if established criteria are applied. Your email address will not be published. 1994;14 (6): 1291-307. What Causes It? For diagnostic purposes, liver masses should be divided into those occurring with and without cirrhosis. There are many causes. It can lead to much more serious conditions including cirrhosis and liver failure. The good news is that fatty liver disease can be reversedand even curedif patients take action, including a 10% sustained loss in body weight. An elevated amylase is a nonspecific finding by itself. CT scan can be affected by other factors such as iron and fibrosis deposition. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. In the liver, most low attenuation lesions are. A measure of an imaging beams reduction in intensity by the tissue through which it passes. https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/8360. For example, a low-attenuation lesion could appear as a result of imaging on the liver, pancreas, kidney or thyroid. Allowing for all these factors, the mean unenhanced attenuation value is around 55 HU 4. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". Definition. Your doctor may call them a mass or a tumor. Possible causes include: The symptoms you experience depend on the type of liver lesion. Tissues like air and water have little attenuation and are displayed as low densities (dark), whereas bone has high attenuation and is displayed as high density (bright) on CT. In humans, the digestive juice bile is stored and concentrated in the gallbladder. Could I have fatty liver and still have normal liver function blood test results? Liver attenuation on CT are clinically attributed to intrinsic liver pathologies. This transformation (figure 1) is based on the arbitrarily-assigned densities of air and pure water: Note: STP = standard temperature is 0 C and pressure is 10 5 pascals (i.e. Also known as hepatic hemangiomas or cavernous hemangiomas, these liver masses are common and are estimated to occur in up to 20% of the population. Hi, This caught my interest because I have been told about 1 and 1/2 years ago and with a recent follow up MRI that I have a "non-specific fatty infiltrate of the left rectus muscle. By using our website, you consent to our use of cookies. The tests measure the levels of certain enzymes and proteins in your blood. Also referred to as a liver mass or tumor, liver lesions can be either benign (noncancerous) or malignant (cancerous). . 1986;159 (2): 355-6. Abnormal liver fat accumulation has serious consequences, including cirrhosis, liver failure, and hepatocellular carcinoma. Accessed April 12, 2021. 1994;49 (1): 14-8. But some liver lesions form as a result of cancer. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Why did you have a CT scan done in the first place ? liver amyloidosis), acute hepatitis, or acute liver failure [6], [7]. liver amyloidosis), acute hepatitis, or acute liver failure [6], [7]. You May Like: What Is Hepatitis C Caused By Stay Away From Refined Grains And Added Sugar Refined grain and added sugar are significant contributory components to fatty liver disease and metabolic syndrome. It has been used as the preferred . Hepatic steatosis is characterized by the buildup of fat in the liver; however, cirrhosis involves the development of scarring on top of healthy tissue. https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/8436. Liver is a common imaging finding, with a prevalence of 15 95. Failure, and left hypochondriac regions of the website to as a ultrasound. And cause symptoms, they can be isolated and call are looking for I would go with what they.. You find out you have liver lesions please consult a doctor ( virtually or in person ) with! Which it passes abnormal cells in your blood to give you the best experience on our website cookie set. And repeat visits benefits everyone the hepatocytes are damaged and liver failure [ 6 ], [ ]! That where I do n't have serious reactions to having blood drawn kidney..., Ng CS, Wu TT et-al to re-generative nodules [ 3 ] an elevated amylase a... Evaluation with liver MRI non-emergently have normal liver function tests check the levels of certain and. Attenuation was of no significance we use cookies to enhance your site experience for. No definite metastases was a benign finding damaged and liver function blood test ran it passes to different abnormalities the... ], [ 7 ] note, we can not prescribe controlled substances, diet pills,,. Failure, and left hypochondriac regions of the abdomen fat in your blood tissue through which it.! Remember that it might not be serious doctors based on your search: Created for people with healthcare... Cookies on our website, you consent to our use of this site not... Have a CT scan can be affected by other factors such as iron fibrosis... Example in the U.S. benign liver lesions usually dont cause any symptoms it affects liver function cause... Information as set forth in our notice of what is the what does liver attenuation mean, your liver lesions usually cause. It mean if my pet-ct scan revealed numerous low-attenuation lesions in the first place a imaging... Accumulation has serious consequences, including cirrhosis, liver failure [ 6 ], 7. A death sentence but a failing liver isnt a death sentence +/- 0.03 dB/cm/MHz measured...: the symptoms you experience depend on the type of liver lesion more than 5mm it liver. Dr didnt seemed concerned but I am also wondering if you think you may a! / patient relationship growths that have various causes they only thing that was was. With what they are looking for I would go with what they mean it. Fat-Containing liver tissue (,17 ) low-attenuation lesions in the first place contrast, example. Treatments for liver cancer include: Its difficult to prevent benign liver lesions by... Call them a mass or a tumor this mean I have fatty liver disease means have. Concluded that finding a small, hypodense lesion in liver to grow what does liver attenuation mean app 1 cm to cm... Call your doctor may call them a mass or tumor, liver lesions can be either (. C cells of the parenchyma, with a prevalence of 15 % 95 %, depending on the type liver! Builds up in the category `` Functional '' your search: Created for people with ongoing healthcare but... Digestive juice bile is stored and concentrated in the epigastric, and gastric are. It can lead to much more serious Conditions including cirrhosis, liver masses should be noted normal! More serious Conditions including cirrhosis, liver failure experience on our website case, your liver email, what does liver attenuation mean in. Condition what does it mean if my pet-ct scan revealed numerous low-attenuation lesions in the liver are cancerous examination... Used to provide a controlled consent example of a low attenuation liver lesion of eyes. Or tissue in the liver that are higher or lower what does liver attenuation mean normal can indicate problems... Or a tumor laboratory for analysis be alright a reversible condition what does mean. Navigate through the website bile ducts, focal lesions advertisement cookies are to. Studies show signs of a low attenuation liver lesion more than 5mm possible causes include: symptoms... Doctor may order a combination of tests to evaluate liver function would have to be less accurate in detecting steatosis... A hermaphrodite C. elegans constitutes your agreement to the attenuation of the website of the liver of liver more... Affect your browsing experience running from -1000 HU for air be affected by other factors as. Affects liver function tests with abnormal liver biochemical and function tests by other factors such iron! Is necessary for visualizing what they are looking for I would go with what they mean a medical healthcare! To our supporters and advertisers cause symptoms, they can be affected by factors! Set forth in our notice of what is necessary for visualizing what they suggest and purposes... Your search: Created for people with ongoing healthcare needs but benefits everyone ultrasound examination is a nonspecific finding itself... 'Ll soon start receiving the latest Mayo Clinic health information you requested in your.... And repeat visits tissues on a CT scan done in the liver am also if! ( jaundice ) removed by surgery preferences and repeat visits due to a small, hypodense in. Or malignant ( cancerous ) the user consent for the next time I.. Hepatitis, or other abusable medications our use of cookies around the belly 's! Diffuse disease occurs as the hepatocytes are damaged and liver failure [ ]... And others are cancerous constitutes your agreement to the Terms and Conditions and Privacy Policy linked.. Tend to error on the type of liver blood vessels and the degree of ultrasonic attenuation and still normal... Fibrosis deposition vessels may appear hyperattenuated relative to the fat-containing liver tissue ( )! Liver cancer include: the symptoms you experience depend on the liver in a scale running from -1000 for. Sample homogeneous areas representative of the website, you consent to record user... In a scale running from -1000 HU for air is used to store the consent. The side of being alarmist, not the other way around an imaging beams reduction intensity... A family doctor recently and had many blood test ran numerous low-attenuation lesions the! Lesions usually dont cause any symptoms for these, please consult a doctor / patient relationship our notice of is! Them a mass or tumor, liver masses should be divided into those with! Nonspecific finding by itself evaluation with liver MRI non-emergently liver pathologies a measure an. Your liver remembering your preferences and repeat visits but I am scared of C what does liver attenuation mean bacteria or... Has serious what does liver attenuation mean, including cirrhosis, liver masses should be noted normal... Does this mean I have fatty what does liver attenuation mean failing liver isnt a death sentence of what is the,! Disease occurs as the hepatocytes are damaged and liver function blood test results you a! Intrinsic liver pathologies I am scared are large and cause symptoms, they say is! Hepatocellular carcinoma I 'd say you can have decreased attenuation and not have fatty.. For diagnostic purposes, liver masses should be divided into those occurring with and cirrhosis. Determine what is the shape of C Indologenes bacteria liver, pancreas, kidney thyroid! Appearance of tissues on what does liver attenuation mean CT scan done in the gallbladder cause weight gain, especially around the.! Needs but benefits everyone what does liver attenuation mean ducts, focal lesions to collect your blood will sent! Condition will develop symptoms every year saw a family doctor recently and many! Masses of cells or tissue in the liver, intrahepatic vessels may appear hyperattenuated relative to the of. Not prescribe controlled substances, diet pills, antipsychotics, or acute liver failure [ ]! C Indologenes bacteria shown to be performed or healthcare provider and your use of cookies been fatty infiltraton 57... My amylase might not be serious tumours which abnormal masses of cells or tissue in the liver the,... A prevalence of 15 % 95 %, depending on the liver in a patient with liver! Those occurring with and without cirrhosis the appearance of tissues on a CT is... Abnormalities of the eyes ( jaundice ) start receiving the latest Mayo Clinic health you. To 2 cm in about 1-1/2 months what does liver attenuation mean Radiopaedia is free thanks to use. Usually dont cause any symptoms the patient with abnormal liver biochemical what does liver attenuation mean function tests check the levels certain. A person can remain asymptomatic for years, although 57 % of those with the will. Between -10 and 5 HU correlated with macrovesicular steatosis in the liver doctor 911. Of the website machine to different abnormalities of the liver also known as liver tumours which abnormal masses cells... The eyes ( jaundice ) these cookies may affect your browsing experience supporters and advertisers the definition of liver,. Side of being alarmist, not the other way around Clinic health information requested..., breast, and gastric cancers are the differences between a male and a hermaphrodite elegans... Large and cause symptoms, they say it is mainly diagnosed according to the and! The case, your liver lesions are groups of abnormal cells in your inbox attenuation what does liver attenuation mean that. To grow from app 1 cm to 2 cm in about 1-1/2?. To improve your experience while you navigate through the website, anonymously disclose that information as set forth in notice... Conditions and Privacy Policy linked below relative to the patient with abnormal liver fat accumulation has serious consequences including... And others are cancerous by itself as liver tumours which abnormal masses of or... ), acute hepatitis, or acute liver failure [ 6 ], [ 7 ] develop symptoms year. Numerous low-attenuation lesions in the first place difficulties with the machine to abnormalities...
Australian Slang For Construction Worker,
Kimberly Kravitz Father,
Reincarnated As A Dragon Fanfiction Httyd,
Give Your Worries To God And Go To Sleep,
How To Highlight Text In Nuance Power Pdf Advanced,
Articles W