Hepatocellular carcinoma CT: Difference between revisions
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==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 or subtle 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. | |||
Abdominal 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><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> | |||
== | **Enhanced mass during the arterial phase | ||
**Wedge shaped perfusion abnormality because of the arterioportal shunts (APS) | |||
*Focal HCC | **Focal fatty change in the normal live | ||
**Focal fatty sparing in the diffusely fatty liver | |||
**Halo of focal fatty sparing around the hepatocellular carcinoma | |||
The following appearances may be noted on the CT examination: | |||
*Massive HCC | |||
:*large usually hypoattenuating mass | :*large usually hypoattenuating mass | ||
:*May have necrosis/fat/calcification | :*May have necrosis/fat/calcification | ||
Revision as of 18:59, 9 January 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]
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Hepatocellular carcinoma Microchapters |
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Differentiating Hepatocellular carcinoma from other Diseases |
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Hepatocellular carcinoma CT On the Web |
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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) to increase the ability of the radiologist to detect small or subtle 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. Findings on CT scan suggestive of hepatocellular carcinoma include:[1][2][1]
- Enhanced mass during the arterial phase
- Wedge shaped perfusion abnormality because of the arterioportal shunts (APS)
- Focal fatty change in the normal live
- Focal fatty sparing in the diffusely fatty liver
- Halo of focal fatty sparing around the hepatocellular carcinoma
The following appearances may be noted on the CT examination:
- Massive HCC
- large usually hypoattenuating mass
- May have necrosis/fat/calcification
- Multifocal HCC
- Multiple masses of variable attenuation lesions
- May also have central hypoattenuating necrotic portions
- Diffuse HCC
- May be difficult to distinguish from associated cirrhosis
References
- ↑ 1.0 1.1 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.
- ↑ "Hepatocellular carcinoma | Radiology Case | Radiopaedia.org".
- ↑ "Diffuse hepatocellular cancer with malignant portal vein thrombosis | Radiology Case | Radiopaedia.org".