Hepatocellular carcinoma CT
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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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 the best method 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.
Key CT Findings in Hepatocellular Carcinoma CT Scan
On CT, hepatocellular carcinoma can have three distinct patterns of growth:
- A single large tumor
- Multiple tumors
- Poorly defined tumor with an infiltrative growth pattern
Other key characteristics findings on CT are:
- Hypervascularity in the arterial phase scans
- Washout or de-enhancement in the portal and delayed phase studies
- Pseudocapsule and a mosaic pattern
- Calcifications
- Intralesional fat
CT scans use contrast agents, which are typically iodine or barium based. Some patients are allergic to one or both of these contrast agents, most often iodine. Usually the allergic reaction is manageable and not life threatening.