Hepatocellular carcinoma of diffuse type: MR imaging findings and clinical manifestations
Open Access
- 21 July 2003
- journal article
- research article
- Published by Wiley in Journal of Magnetic Resonance Imaging
- Vol. 18 (2), 189-195
- https://doi.org/10.1002/jmri.10336
Abstract
Purpose: To assess MR imaging findings and clinical manifestations of diffuse-type hepatocellular carcinoma (HCC). Materials and Methods: We retrospectively reviewed our experience with diffuse HCC from November 1994 to October 2001. MR imaging findings and clinical features were assessed. Results: Twenty-two consecutive patients with diffuse-type HCC (19 men and three women, age range 16–80 years [mean, 52 years]) were identified in a review of liver MR studies. This represented 13% of all patients with HCC imaged during this time period. Diffuse HCC showed a permeative, infiltrative pattern with ill-defined borders and no evidence of convex margination in all cases. At least 50% of the liver volume was involved with tumor. Diffuse-type HCC showed hypointensity in 15 patients, mixed intensity in three, and isointensity in four on T1-weighted images; heterogeneous hyperintensity in 16 patients; and homogeneous hyperintensity in six on T2-weighted MR images. Diffuse-type HCC showed patchy enhancement in 12 patients, miliary enhancement in nine, and minimal enhancement in one on postcontrast early-phase images, and showed heterogeneous wash-out in all patients on postcontrast late-phase images. Proximal portal venous tumor thrombosis was seen in all patients. Serum α-fetoprotein (AFP) value was elevated (>10 ng/mL) in 14 of 18 patients, and 13 showed a value greater than 500 ng/mL. The four patients who did not have elevated AFP had tumors which were indistinguishable from those in patients with elevated AFP; they also did not have a distinctive clinical history. Conclusion: Diffuse-type HCC was typically seen as an extensive, heterogeneous permeative hepatic tumor, with portal venous tumor thrombosis on MR images in all cases. Early enhancement, observed as patchy in 12 and miliary in nine of 22 patients, was a distinctive imaging feature. Elevated serum AFP value was a common finding; however, 22% had normal values. J. Magn. Reson. Imaging 2003;18:189–195.This publication has 15 references indexed in Scilit:
- Racial differences in effectiveness of α-fetoprotein for diagnosis of hepatocellular carcinoma in hepatitis C virus cirrhosisJournal of Hepatology, 2002
- Pretransplantation Surveillance for Possible Hepatocellular Carcinoma in Patients with Cirrhosis: Epidemiology and CT-based Tumor Detection Rate in 430 Cases with Surgical Pathologic CorrelationRadiology, 2000
- National Institutes of Health Consensus Development Conference Panel statement: Management of hepatitis CJournal of Hepatology, 1997
- Hepatitis B and C virus infection, alcohol drinking, and hepatocellular carcinoma: A case-control study in ItalyJournal of Hepatology, 1997
- Benign and malignant portal vein thrombosis: differentiation by CT characteristics.American Journal of Roentgenology, 1997
- Screening for hepatocellular carcinoma in chronic carriers of hepatitis B virus: Incidence and prevalence of hepatocellular carcinoma in a North American urban populationJournal of Hepatology, 1995
- Specificities of serum α-fetoprotein in HBsAg+ and HBsAg− patients in the diagnosis of hepatocellular carcinomaJournal of Hepatology, 1991
- Survival and Causes of Death in Cirrhotic and in Noncirrhotic Patients with Primary HemochromatosisThe New England Journal of Medicine, 1985
- Transient hepatic attenuation difference of lobar or segmental distribution detected by dynamic computed tomography.Radiology, 1982
- A clinical and pathological study of diffuse type hepatocellular carcinomaLiver International, 1981