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CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2022; 05(03): 135-139
DOI: 10.1055/s-0042-1742771
Original Article

Typical and Atypical Imaging Findings of Hepatocellular Carcinoma on Multiphasic MDCT Scan in Histologically Proved Cases

Umakant Prasad
1   Department of Radiodiagnosis, Indira Gandhi Institute of Medical Science, Patna, Bihar, India
,
Deepak Kumar
1   Department of Radiodiagnosis, Indira Gandhi Institute of Medical Science, Patna, Bihar, India
,
Rashmi Rani Bharti
2   Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar
,
Sanjay Kumar Suman
1   Department of Radiodiagnosis, Indira Gandhi Institute of Medical Science, Patna, Bihar, India
,
Aishwerya Singh
1   Department of Radiodiagnosis, Indira Gandhi Institute of Medical Science, Patna, Bihar, India
,
Ravikant Kumar
3   Department of Gastroentrology, Indira Gandhi Institute of Medical Science, Patna, India
› Author Affiliations Funding None.
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Abstract

Objective The purpose of this study was to find out the incidence of typical and atypical radiological imaging findings of hepatocellular carcinoma (HCC) on multiphase multidetector computed tomography (MDCT) scans in histologically proven cases.

Materials and Methods A multiphase computed tomography study of 73 patients with histologically proven HCC was evaluated by a radiologist. Our multiphasic protocol was composed of precontrast, arterial, portal, and delayed venous phases. The reviewers analyzed the CT images for tumor size, enhancement patterns of HCC in different phases, relative timing of washout, internal cystic changes, and presence of dysmorphic intratumoral vessel aneurysms or arteriovenous shunt.

Results Most of the cases (95.9%) showed typical enhancement patterns in MDCT, i.e., enhancements in the arterial phase with the portal or delayed venous phase contrast washout. Three cases (4.9%) out of 73 HCC showed enhancements in the portal phase and washout in the delayed venous phase. Seven cases out of total 73 HCC (9.5%) patients showed heterogeneous enhancements in both arterial and portal phases and contrast washout in the delayed venous phase. Venous thrombosis was noted in about 44 cases (60%) out of total 73 patients, in which portal vein thrombosis was more common than hepatic veins/inferior vena cava.

Conclusion Most of the HCC show typical enhancement patterns, i.e., heterogeneous enhancements in the arterial phase and washout in the portal venous phase when we use MDCT. These findings are higher than those described previously. However, in our study, the main difference with MDCT was lower frequency of intratumoral pseudoaneurysm and bile duct invasion, and intratumoral fat and calcification (atypical character of HCC) were not found which were rare findings in previous study.

Keywords

HCC - Cystic changes - Multiphasic MDCT scan - Intratumoral pseudoaneurysm


Publication History

Article published online:
18 February 2022

© 2022. Indian Society of Gastrointestinal and Abdominal Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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