Hepatocellular carcinoma CT
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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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]
- 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
| Type | Appearance |
|---|---|
| Massive HCC | Large hypoattenuating mass
May have necrosis/fat/calcification |
| Nodular HCC | Multiple masses of different attenuation are observed
Central necrosis may be observed |
| Infiltrative HCC | May be difficult to distinguish from associated cirrhosis |
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.