scholarly journals Value of delayed hypointensity and delayed enhancing rim in magnetic resonance imaging diagnosis of small hepatocellular carcinoma in the cirrhotic liver

2010 ◽  
Vol 32 (2) ◽  
pp. 360-366 ◽  
Author(s):  
Asra S. Khan ◽  
Hero K. Hussain ◽  
Timothy D. Johnson ◽  
William J. Weadock ◽  
Shawn J. Pelletier ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Cirrhotic Liver ◽  
Small Hepatocellular Carcinoma ◽  
Resonance Imaging ◽  
Imaging Diagnosis

scholarly journals Pathobiological and Radiological Approach For Hepatocellular Carcinoma Subclassification

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Francesco Vasuri ◽  
Matteo Renzulli ◽  
Silvia Fittipaldi ◽  
Stefano Brocchi ◽  
Alfredo Clemente ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Histopathological Analysis ◽  
Resonance Imaging ◽  
Imaging Diagnosis ◽  
Mri Features ◽  
Histopathological Evaluation ◽  
Magnetic Resonance Imaging Mri ◽  
Made In

Abstract Many advances have been made in the imaging diagnosis and in the histopathological evaluation of HCC. However, the classic imaging and histopathological features of HCC are still inadequate to define patient’s prognosis. We aimed to find the link between new proposed morphovascular patterns of hepatocellular carcinoma (HCC) and magnetic resonance imaging (MRI) features to identify pre-operatory markers of biologically aggressive HCC. Thirty-nine liver nodules in 22 patients were consecutively identified. Histopathological analysis and immunohistochemistry for CD34 and Nestin were performed to identify the four different HCC morphovascular patterns. MRI was performed using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid. Three out of four morphovascular HCC patterns showed peculiar MRI features: in particular Pattern D (solid aggressive HCCs with CD34+/Nestin+ new-formed arteries) were isointense on T1-WI in 83% of cases and hyperintense on T2-WI in 50%. Five histologically-diagnosed HCC were diagnosed as non-malignant nodules on MRI due to their early vascularization and low aggressiveness (Pattern A). The comparison between histology and MRI confirms that a subclassification of HCC is possible in a pre-operatory setting. MRI seems to reinforce once more the identity of the different morphovascular HCC patterns and the possibility to pre-operatively identify HCCs with features of biological aggressiveness.

scholarly journals Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment - Part 1

2017 ◽  
Vol 50 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Magnetic Resonance ◽  
Cirrhotic Liver ◽  
Response To Treatment ◽  
Arterial Phase ◽  
Resonance Imaging ◽  
Regenerative Nodules ◽  
Magnetic Resonance Imaging Mri

Abstract Magnetic resonance imaging (MRI) is the modern gold standard for the noninvasive evaluation of the cirrhotic liver. The combination of arterial phase hyperenhancement and delayed wash-out allows a definitive diagnosis of hepatocellular carcinoma (HCC) in patients with liver cirrhosis or chronic liver disease, without the requirement for confirmatory biopsy. That pattern is highly specific and has been endorsed in Western and Asian diagnostic guidelines. However, the sensitivity of the combination is relatively low for small HCCs. In this two-part review paper, we will address MRI of the cirrhotic liver. In this first part, we provide a brief background on liver cirrhosis and HCC, followed by descriptions of imaging surveillance of liver cirrhosis and the diagnostic performance of the different imaging modalities used in clinical settings. We then describe some of the requirements for the basic MRI technique, as well as the standard MRI protocol, and provide a detailed description of the appearance of various types of hepatocellular nodules encountered in the setting of the carcinogenic pathway in the cirrhotic liver, ranging from regenerative nodules to HCC.

scholarly journals An overview of hepatocellular carcinoma with atypical enhancement pattern: spectrum of magnetic resonance imaging findings with pathologic correlation

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jelena Djokic Kovac ◽  
Aleksandar Ivanovic ◽  
Tamara Milovanovic ◽  
Marjan Micev ◽  
Francesco Alessandrino ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Cirrhotic Liver ◽  
Hepatobiliary Phase ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Enhancement Pattern ◽  
Diffusion Restriction ◽  
Mri Features

Abstract Background In the setting of cirrhotic liver, the diagnosis of hepatocellular carcinoma (HCC) is straightforward when typical imaging findings consisting of arterial hypervascularity followed by portal-venous washout are present in nodules larger than 1 cm. However, due to the complexity of hepatocarcinogenesis, not all HCCs present with typical vascular behaviour. Atypical forms such as hypervascular HCC without washout, isovascular or even hypovascular HCC can pose diagnostic dilemmas. In such cases, it is important to consider also the appearance of the nodules on diffusion-weighted imaging and hepatobiliary phase. In this regard, diffusion restriction and hypointensity on hepatobiliary phase are suggestive of malignancy. If both findings are present in hypervascular lesion without washout, or even in iso- or hypovascular lesion in cirrhotic liver, HCC should be considered. Moreover, other ancillary imaging findings such as the presence of the capsule, fat content, signal intensity on T2-weighted image favour the diagnosis of HCC. Another form of atypical HCCs are lesions which show hyperintensity on hepatobiliary phase. Therefore, the aim of the present study was to provide an overview of HCCs with atypical enhancement pattern, and focus on their magnetic resonance imaging (MRI) features. Conclusions In order to correctly characterize atypical HCC lesions in cirrhotic liver it is important to consider not only vascular behaviour of the nodule, but also ancillary MRI features, such as diffusion restriction, hepatobiliary phase hypointensity, and T2-weighted hyperintensity. Fat content, corona enhancement, mosaic architecture are other MRI feautures which favour the diagnosis of HCC even in the absence of typical vascular profile.

Small Hepatocellular Carcinoma on Magnetic Resonance Imaging

1997 ◽  
Vol 32 (3) ◽  
pp. 161-168 ◽  
Author(s):  
HIROSHI HONDA ◽  
KUNIYUKI KANEKO ◽  
TAKASHI MAEDA ◽  
TOSHIROU KUROIWA ◽  
TATSUROU FUKUYA ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Small Hepatocellular Carcinoma ◽  
Resonance Imaging

scholarly journals Magnetic Resonance Imaging Diagnosis of Hepatocellular Carcinoma in Cirrhotic Patients: Where Are We Now?

2016 ◽  
Vol 29 (5) ◽  
pp. 293
Author(s):  
Miguel Ramalho ◽  
Mamdoh AlObaidy ◽  
António P. Matos ◽  
Richard C. Semelka
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Imaging Diagnosis ◽  
Cirrhotic Patients

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