Hepatocellular carcinoma MRI: Difference between revisions
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{{Hepatocellular carcinoma}} | {{Hepatocellular carcinoma}} | ||
{{CMG}} {{AE}} {{ | {{CMG}} {{AE}} {{SH}} | ||
==Overview== | ==Overview== | ||
MRI may be helpful in the diagnosis of hepatocellular carcinoma. | [[Magnetic resonance imaging|MRI]] may be helpful in the [[diagnosis]] of hepatocellular carcinoma (HCC). Hepatocyte-specific magnetic resonance [[contrast agents]] are used in some parts of the world to improve the accuracy of minimally invasive daignostic techniques. | ||
==Key Findings in MRI in Hepatocellular Carcinoma== | ==Key Findings in MRI in Hepatocellular Carcinoma== | ||
Common findings of hepatocellular carcinoma on MRI: | Common findings of hepatocellular carcinoma on [[Magnetic resonance imaging|MRI]] include the following:<ref name="pmid22700119">{{cite journal |vauthors=Campos JT, Sirlin CB, Choi JY |title=Focal hepatic lesions in Gd-EOB-DTPA enhanced MRI: the atlas |journal=Insights Imaging |volume=3 |issue=5 |pages=451–74 |year=2012 |pmid=22700119 |pmc=3443279 |doi=10.1007/s13244-012-0179-7 |url=}}</ref><ref name="pmid18430871">{{cite journal |vauthors=Willatt JM, Hussain HK, Adusumilli S, Marrero JA |title=MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies |journal=Radiology |volume=247 |issue=2 |pages=311–30 |year=2008 |pmid=18430871 |doi=10.1148/radiol.2472061331 |url=}}</ref><ref name="pmid227001192">{{cite journal |vauthors=Campos JT, Sirlin CB, Choi JY |title=Focal hepatic lesions in Gd-EOB-DTPA enhanced MRI: the atlas |journal=Insights Imaging |volume=3 |issue=5 |pages=451–74 |year=2012 |pmid=22700119 |pmc=3443279 |doi=10.1007/s13244-012-0179-7 |url=}}</ref><ref name="pmid23049491">{{cite journal |vauthors=Albiin N |title=MRI of Focal Liver Lesions |journal=Curr Med Imaging Rev |volume=8 |issue=2 |pages=107–116 |year=2012 |pmid=23049491 |pmc=3462338 |doi=10.2174/157340512800672216 |url=}}</ref><ref name="pmid14657326">{{cite journal |vauthors=Murakami T, Kim T, Hori M, Federle MP |title=Double arterial phase multi-detector row helical CT for detection of hypervascular hepatocellular carcinoma |journal=Radiology |volume=229 |issue=3 |pages=931–2 |year=2003 |pmid=14657326 |doi=10.1148/radiol.2293030590 |url=}}</ref><ref name="pmid26603785">{{cite journal |vauthors=Terzi E, Salvatore V, Negrini G, Piscaglia F |title=Ongoing challenges in the diagnosis of hepatocellular carcinoma |journal=Expert Rev Gastroenterol Hepatol |volume=10 |issue=4 |pages=451–63 |year=2016 |pmid=26603785 |doi=10.1586/17474124.2016.1124758 |url=}}</ref> | ||
* On [[T1 relaxography|T1]]-weighted MR images, [[hepatocellular carcinoma]] is most often hypointense relative to the [[liver]], although hyperintense [[Lesion|lesions]] or areas of hyperintensity within hypointense lesions may be seen. | |||
** These hyperintense regions within the hepatocellular carcinoma reflect the presence of [[fat]], [[copper]], [[protein]], or [[blood]] secondary to intralesional [[hemorrhage]]. | |||
* On T2-weighted images, hepatocellular carcinoma is generally hyperintense, although well-differentiated lesions that are isointense relative to the [[liver]] parenchyma may be seen. | |||
* On T2-weighted images, hepatocellular carcinoma is generally hyperintense, although well-differentiated lesions that are isointense relative to the liver parenchyma may be seen. | |||
* Most hepatocellular carcinomas show '''intense enhancement on arterial phase contrast-enhanced images'''. | * Most hepatocellular carcinomas show '''intense enhancement on arterial phase contrast-enhanced images'''. | ||
* A large hepatocellular carcinoma (>5 cm) may have a number of characteristic features, such as | * A large hepatocellular carcinoma (>5 cm) may have a number of characteristic features, such as: | ||
** The mosaic pattern is created by confluent small nodules separated by thin septa and necrotic areas within the tumor. This pattern is more often depicted on T2-weighted MR images than on T1-weighted images. | ** Mosaic pattern | ||
** [[Tumor]] capsule | |||
** Extracapsular extension with formation of satellite nodules | |||
** [[Vascular]] invasion | |||
** Extrahepatic dissemination, including [[lymph node]] and distant [[metastases]] | |||
** The mosaic pattern is created by confluent small nodules separated by thin septa and [[necrotic]] areas within the [[tumor]]. This pattern is more often depicted on T2-weighted [[Magnetic resonance imaging|MR]] images than on T1-weighted images. | |||
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==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Types of cancer]] | [[Category:Types of cancer]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Hepatology]] | |||
[[Category:Radiology]] | |||
[[Category:Surgery]] | |||
[[Category:Emergency medicine]] | |||
Latest revision as of 22:08, 29 July 2020
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Hepatocellular carcinoma Microchapters |
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Differentiating Hepatocellular carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatocellular carcinoma MRI On the Web |
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American Roentgen Ray Society Images of Hepatocellular carcinoma MRI |
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Risk calculators and risk factors for Hepatocellular carcinoma MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Overview
MRI may be helpful in the diagnosis of hepatocellular carcinoma (HCC). Hepatocyte-specific magnetic resonance contrast agents are used in some parts of the world to improve the accuracy of minimally invasive daignostic techniques.
Key Findings in MRI in Hepatocellular Carcinoma
Common findings of hepatocellular carcinoma on MRI include the following:[1][2][3][4][5][6]
- On T1-weighted MR images, hepatocellular carcinoma is most often hypointense relative to the liver, although hyperintense lesions or areas of hyperintensity within hypointense lesions may be seen.
- These hyperintense regions within the hepatocellular carcinoma reflect the presence of fat, copper, protein, or blood secondary to intralesional hemorrhage.
- On T2-weighted images, hepatocellular carcinoma is generally hyperintense, although well-differentiated lesions that are isointense relative to the liver parenchyma may be seen.
- Most hepatocellular carcinomas show intense enhancement on arterial phase contrast-enhanced images.
- A large hepatocellular carcinoma (>5 cm) may have a number of characteristic features, such as:
- Mosaic pattern
- Tumor capsule
- Extracapsular extension with formation of satellite nodules
- Vascular invasion
- Extrahepatic dissemination, including lymph node and distant metastases
- The mosaic pattern is created by confluent small nodules separated by thin septa and necrotic areas within the tumor. This pattern is more often depicted on T2-weighted MR images than on T1-weighted images.
{{#ev:youtube|PQXb5D-5UZw}} {{#ev:youtube|CdAiLvyy3Po}} {{#ev:youtube|qbv7v6bonrI}}
References
- ↑ Campos JT, Sirlin CB, Choi JY (2012). "Focal hepatic lesions in Gd-EOB-DTPA enhanced MRI: the atlas". Insights Imaging. 3 (5): 451–74. doi:10.1007/s13244-012-0179-7. PMC 3443279. PMID 22700119.
- ↑ Willatt JM, Hussain HK, Adusumilli S, Marrero JA (2008). "MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies". Radiology. 247 (2): 311–30. doi:10.1148/radiol.2472061331. PMID 18430871.
- ↑ Campos JT, Sirlin CB, Choi JY (2012). "Focal hepatic lesions in Gd-EOB-DTPA enhanced MRI: the atlas". Insights Imaging. 3 (5): 451–74. doi:10.1007/s13244-012-0179-7. PMC 3443279. PMID 22700119.
- ↑ Albiin N (2012). "MRI of Focal Liver Lesions". Curr Med Imaging Rev. 8 (2): 107–116. doi:10.2174/157340512800672216. PMC 3462338. PMID 23049491.
- ↑ Murakami T, Kim T, Hori M, Federle MP (2003). "Double arterial phase multi-detector row helical CT for detection of hypervascular hepatocellular carcinoma". Radiology. 229 (3): 931–2. doi:10.1148/radiol.2293030590. PMID 14657326.
- ↑ Terzi E, Salvatore V, Negrini G, Piscaglia F (2016). "Ongoing challenges in the diagnosis of hepatocellular carcinoma". Expert Rev Gastroenterol Hepatol. 10 (4): 451–63. doi:10.1586/17474124.2016.1124758. PMID 26603785.