Hepatocellular carcinoma-CT

Chronic alcoholic:  liver is shrunken with  cirrhotic texture and prominent caudate lobe.Rounded focal lesion is seen in the hepatic dome. The lesion is inconspicuous in the pre-contrast scan showing same density of the liver parenchyma, with enhancement in the arterial phase and becomes isoattenuating in the venous and delayed phases.

Teaching Points

  • Hepatocellular carcinoma receives most of its blood supply from the hepatic artery
  •  Enhancement pattern is the key to correct assessment of HCCs. Usually the mass enhances vividly during late arterial (~35 seconds) and then washes out, becoming indistinct or hypoattenuating in the portal venous phase, compared to the rest of the liver.
  • Hepatocellular carcinomas can have a variety of appearances: including focal, mutiple and diffuse

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