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  • Title: Multiphasic MDCT enhancement pattern of hepatocellular carcinoma smaller than 3 cm in diameter: tumor size and cellular differentiation.
    Author: Yoon SH, Lee JM, So YH, Hong SH, Kim SJ, Han JK, Choi BI.
    Journal: AJR Am J Roentgenol; 2009 Dec; 193(6):W482-9. PubMed ID: 19933622.
    Abstract:
    OBJECTIVE: The purpose of this study was to evaluate according to size and degree of cellular differentiation the multiphasic MDCT enhancement pattern of hepatocellular carcinoma (HCC) smaller than 3 cm in diameter in patients with cirrhosis. MATERIALS AND METHODS: In 155 consecutively registered patients (126 men, 29 women; mean age, 58.4 years), 204 pathologically proven HCCs smaller than 3 cm were detected at multiphasic MDCT. Three radiologists in consensus classified the relative attenuation of the tumors compared with the surrounding liver parenchyma as hyperattenuation, isoattenuation, or hypoattenuation on biphasic (n = 86) and triphasic (n = 69) CT scans. RESULTS: The prevalent enhancement patterns of HCC differed depending on tumor size. The prevalent pattern of HCC measuring 20-29 mm was arterial hyperattenuation with venous washout (47%, 47/101). The prevalent enhancement patterns of HCC smaller than 10 mm and HCC measuring 10-19 mm were isoattenuation during the arterial and portal venous phases (29%, 6/21) and hyperattenuation and isoattenuation during the arterial and portal venous phases (33%, 27/82). The typical HCC enhancement pattern (arterial hyperattenuation with venous washout) was identified in 48% (67/141) of the moderately and poorly differentiated HCCs and in 13% (8/63) of well-differentiated HCCs. CONCLUSION: The prevalent enhancement patterns of HCC smaller than 3 cm on multiphasic MDCT scans differed depending on tumor size and cellular differentiation. HCCs smaller than 2 cm and well-differentiated HCCs frequently had atypical enhancement patterns.
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