Enhancement patterns and signal-intensity characteristics of small hepatocellular carcinoma in cirrhosis: pathologic basis and diagnostic challenges

Autor: Prodromos Hytiroglou, Osamu Matsui, S. C. Efremidis
Rok vydání: 2007
Předmět:
Diagnostic Imaging
medicine.medical_specialty
Pathology
Carcinoma
Hepatocellular
Cirrhosis
Fibrosis/*complications/*diagnosis
Medical Oncology/methods
Carcinoma
Hepatocellular/*complications/*diagnosis/pathology
Tomography
X-Ray Computed/*methods
Medical Oncology
Models
Biological
Sensitivity and Specificity
Diagnosis
Differential
Diagnostic Imaging/methods
medicine
Carcinoma
Humans
Radiology
Nuclear Medicine and imaging
Neuroradiology
medicine.diagnostic_test
Liver Diseases/complications/pathology
business.industry
Liver Diseases
Liver Neoplasms
Hepatitis C/complications/pathology
Magnetic resonance imaging
General Medicine
HCCS
medicine.disease
Fibrosis
Hepatitis C
Magnetic Resonance Imaging
digestive system diseases
Transplantation
Hepatocellular carcinoma
Liver Neoplasms/*complications/*diagnosis/pathology
Radiology
Differential diagnosis
Tomography
X-Ray Computed
business
Magnetic Resonance Imaging/*methods
Zdroj: European Radiology. 17:2969-2982
ISSN: 1432-1084
0938-7994
DOI: 10.1007/s00330-007-0705-z
Popis: Recent pathologic studies of hepatic resection and transplantation specimens have elucidated the morphologic features of the precancerous lesions and small hepatocellular carcinomas (HCCs) arising in cirrhotic livers. Small HCCs measuring less than 2 cm in diameter are of two types: vaguely nodular, well-differentiated tumors, also known as "early" HCCs, and distinctly nodular tumors, with histologic features of "classic" HCC. The precancerous lesions include dysplastic foci and dysplastic nodules. "Classic" small HCCs are supplied by nontriadal arteries, whereas early HCCs and dysplastic nodules may receive blood supply from both portal tracts and nontriadal arteries. The similarities in blood supply of these three types of nodular lesions result in significant overlap of findings on dynamic imaging. Nevertheless, small HCCs sometimes display characteristic radiologic features, such as "nodule-in-nodule" configuration and "corona enhancement" pattern. Moreover, various histologic features of these nodular lesions may also be related to a variety of signal intensities and attenuation coefficients, while the presence of cirrhosis is known to limit the sensitivity and specificity of any imaging modality, due to liver inhomogeneity. Because of these reasons, imaging findings of nodular lesions in cirrhotic livers are often inconclusive, emphasizing the need for a better understanding of these imaging features. European Radiology
Databáze: OpenAIRE
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