Hepatocellular carcinoma CT: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{CMG}} {{AE}} {{ | {{CMG}} {{AE}} {{SH}} | ||
{{Hepatocellular carcinoma}} | {{Hepatocellular carcinoma}} | ||
==Overview== | ==Overview== | ||
Abdominal CT scan with intravenous contrast agent is used to diagnose hepatocellular carcinoma. Three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) to increase the ability of the [[radiologist]] to detect small | [[Abdominal]] [[Computed tomography|CT scan]] with [[intravenous]] [[contrast agent]] is used to [[diagnose]] hepatocellular carcinoma. Three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) is employed to increase the ability of the [[radiologist]] to detect small [[tumors]]. It is important to optimize the parameters of the CT examination, because the underlying liver disease (e.g. [[hepatitis B]]) that most hepatocellular carcinoma patients have can make the findings more difficult to appreciate. | ||
==CT scan== | ==CT scan== | ||
*Abdominal CT scan may be helpful in the diagnosis of hepatocellular carcinoma. Findings on CT scan suggestive of hepatocellular carcinoma include:<ref name="pmid18356450">{{cite journal |vauthors=Kim KW, Kim MJ, Lee SS, Kim HJ, Shin YM, Kim PN, Lee MG |title=Sparing of fatty infiltration around focal hepatic lesions in patients with hepatic steatosis: sonographic appearance with CT and MRI correlation |journal=AJR Am J Roentgenol |volume=190 |issue=4 |pages=1018–27 |year=2008 |pmid=18356450 |doi=10.2214/AJR.07.2863 |url=}}</ref><ref name="pmid25763723">{{cite journal |vauthors=Reynolds AR, Furlan A, Fetzer DT, Sasatomi E, Borhani AA, Heller MT, Tublin ME |title=Infiltrative hepatocellular carcinoma: what radiologists need to know |journal=Radiographics |volume=35 |issue=2 |pages=371–86 |year=2015 |pmid=25763723 |doi=10.1148/rg.352140114 |url=}}</ref> | *[[Abdominal]] [[Computed tomography|CT scan]] may be helpful in the [[diagnosis]] of hepatocellular carcinoma (HCC). | ||
*Findings on [[Computed tomography|CT scan]] suggestive of hepatocellular carcinoma include the following:<ref name="pmid18356450">{{cite journal |vauthors=Kim KW, Kim MJ, Lee SS, Kim HJ, Shin YM, Kim PN, Lee MG |title=Sparing of fatty infiltration around focal hepatic lesions in patients with hepatic steatosis: sonographic appearance with CT and MRI correlation |journal=AJR Am J Roentgenol |volume=190 |issue=4 |pages=1018–27 |year=2008 |pmid=18356450 |doi=10.2214/AJR.07.2863 |url=}}</ref><ref name="pmid25763723">{{cite journal |vauthors=Reynolds AR, Furlan A, Fetzer DT, Sasatomi E, Borhani AA, Heller MT, Tublin ME |title=Infiltrative hepatocellular carcinoma: what radiologists need to know |journal=Radiographics |volume=35 |issue=2 |pages=371–86 |year=2015 |pmid=25763723 |doi=10.1148/rg.352140114 |url=}}</ref><ref name="pmid27788724">{{cite journal |vauthors=Gao HQ, Hu CH, Yu YX, Hu S, Shi C, Wang XM, Guo L |title=[Value of spectral CT-based quantitative analysis in differential diagnosis of liver cancer and liver abscess] |language=Chinese |journal=Zhonghua Gan Zang Bing Za Zhi |volume=24 |issue=9 |pages=676–680 |year=2016 |pmid=27788724 |doi= |url=}}</ref><ref name="TerziSalvatore2015">{{cite journal|last1=Terzi|first1=Eleonora|last2=Salvatore|first2=Veronica|last3=Negrini|first3=Giulia|last4=Piscaglia|first4=Fabio|title=Ongoing challenges in the diagnosis of hepatocellular carcinoma|journal=Expert Review of Gastroenterology & Hepatology|volume=10|issue=4|year=2015|pages=451–463|issn=1747-4124|doi=10.1586/17474124.2016.1124758}}</ref> | |||
**Enhanced mass during the arterial phase | **Enhanced mass during the arterial phase | ||
**Wedge shaped perfusion abnormality because of the arterioportal shunts (APS) | **Wedge shaped [[perfusion]] abnormality because of the arterioportal shunts (APS) | ||
**Focal fatty change in the normal | **Focal fatty change in the normal [[liver]] | ||
**Focal fatty sparing in the diffusely fatty liver | **Focal fatty sparing in the diffusely fatty [[liver]] | ||
**Halo of focal fatty sparing around the hepatocellular carcinoma | **Halo of focal fatty sparing around the hepatocellular carcinoma | ||
{| class="wikitable" | {| class="wikitable" | ||
!Type | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Type | ||
!Appearance | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Appearance | ||
|- | |- | ||
|Massive HCC | |Massive HCC | ||
|Large hypoattenuating mass | | | ||
May have necrosis/fat/calcification | * Large hypoattenuating mass | ||
* May have [[necrosis]]/fat/calcification | |||
|- | |- | ||
|Nodular HCC | |Nodular HCC | ||
|Multiple masses of different attenuation are observed | | | ||
Central necrosis may be observed | * Multiple masses of different attenuation are observed | ||
* Central [[necrosis]] may be observed | |||
|- | |- | ||
|Infiltrative HCC | |Infiltrative HCC | ||
|May be difficult to distinguish from associated cirrhosis | | | ||
* May be difficult to distinguish from associated [[cirrhosis]] | |||
|} | |} | ||
<gallery widths="250px"> | |||
Image:Massive_HCC.gif |thumb|center|500px|Abdominal CT showing massive hepatocellular carcinoma. Case courtesy of Dr Natalie Yang,<ref name="urlHepatocellular carcinoma | Radiology Case | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/cases/hepatocellular-carcinoma-9 |title=Hepatocellular carcinoma | Radiology Case | Radiopaedia.org |format= |work= |accessdate=}}</ref> | |||
Image:Diffuse_HCC.gif|thumb|center|1000px|Abdominal CT showing diffuse hepatocellular carcinoma. Case courtesy of Dr Ahmed Abd Rabou,<ref name="urlDiffuse hepatocellular cancer with malignant portal vein thrombosis | Radiology Case | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/cases/diffuse-hepatocellular-cancer-with-malignant-portal-vein-thrombosis |title=Diffuse hepatocellular cancer with malignant portal vein thrombosis | Radiology Case | Radiopaedia.org |format= |work= |accessdate=}}</ref> | |||
</gallery> | |||
==References== | ==References== | ||
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{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
[[Category:Disease]] | |||
[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Types of cancer]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Hepatology]] | [[Category:Hepatology]] | ||
[[Category: | [[Category:Radiology]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Emergency medicine]] | |||
Latest revision as of 22:07, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
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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 CT On the Web |
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American Roentgen Ray Society Images of Hepatocellular carcinoma CT |
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Risk calculators and risk factors for Hepatocellular carcinoma CT |
Overview
Abdominal CT scan with intravenous contrast agent is used to diagnose hepatocellular carcinoma. Three-phase scanning (before contrast administration, immediately after contrast administration, and again after a delay) is employed to increase the ability of the radiologist to detect small tumors. It is important to optimize the parameters of the CT examination, because the underlying liver disease (e.g. hepatitis B) that most hepatocellular carcinoma patients have can make the findings more difficult to appreciate.
CT scan
- Abdominal CT scan may be helpful in the diagnosis of hepatocellular carcinoma (HCC).
- Findings on CT scan suggestive of hepatocellular carcinoma include the following:[1][2][3][4]
| Type | Appearance |
|---|---|
| Massive HCC |
|
| Nodular HCC |
|
| Infiltrative HCC |
|
-
![Abdominal CT showing massive hepatocellular carcinoma. Case courtesy of Dr Natalie Yang,[5]](/images/a/a1/Massive_HCC.gif)
Abdominal CT showing massive hepatocellular carcinoma. Case courtesy of Dr Natalie Yang,[5]
-
![Abdominal CT showing diffuse hepatocellular carcinoma. Case courtesy of Dr Ahmed Abd Rabou,[6]](/images/4/4b/Diffuse_HCC.gif)
Abdominal CT showing diffuse hepatocellular carcinoma. Case courtesy of Dr Ahmed Abd Rabou,[6]
![Abdominal CT showing massive hepatocellular carcinoma. Case courtesy of Dr Natalie Yang,[5]](/index.php/File:Massive_HCC.gif)
![Abdominal CT showing diffuse hepatocellular carcinoma. Case courtesy of Dr Ahmed Abd Rabou,[6]](/index.php/File:Diffuse_HCC.gif)
References
- ↑ Kim KW, Kim MJ, Lee SS, Kim HJ, Shin YM, Kim PN, Lee MG (2008). "Sparing of fatty infiltration around focal hepatic lesions in patients with hepatic steatosis: sonographic appearance with CT and MRI correlation". AJR Am J Roentgenol. 190 (4): 1018–27. doi:10.2214/AJR.07.2863. PMID 18356450.
- ↑ Reynolds AR, Furlan A, Fetzer DT, Sasatomi E, Borhani AA, Heller MT, Tublin ME (2015). "Infiltrative hepatocellular carcinoma: what radiologists need to know". Radiographics. 35 (2): 371–86. doi:10.1148/rg.352140114. PMID 25763723.
- ↑ Gao HQ, Hu CH, Yu YX, Hu S, Shi C, Wang XM, Guo L (2016). "[Value of spectral CT-based quantitative analysis in differential diagnosis of liver cancer and liver abscess]". Zhonghua Gan Zang Bing Za Zhi (in Chinese). 24 (9): 676–680. PMID 27788724.
- ↑ Terzi, Eleonora; Salvatore, Veronica; Negrini, Giulia; Piscaglia, Fabio (2015). "Ongoing challenges in the diagnosis of hepatocellular carcinoma". Expert Review of Gastroenterology & Hepatology. 10 (4): 451–463. doi:10.1586/17474124.2016.1124758. ISSN 1747-4124.
- ↑ "Hepatocellular carcinoma | Radiology Case | Radiopaedia.org".
- ↑ "Diffuse hepatocellular cancer with malignant portal vein thrombosis | Radiology Case | Radiopaedia.org".