Infiltrative hepatocellular carcinoma: Comparison of MRI sequences for lesion conspicuity

Rosenkrantz, Andrew B.; Lee, L.; Matza, Brent W.; Kim, S.

doi:10.1016/j.crad.2012.08.019

Cited by 45 publications

(31 citation statements)

References 12 publications

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“…The enhancement pattern of infiltrative HCC seen on images obtained during the hepatic arterial phase has been reported as minimal, patchy, or miliary (10,13,17,32,39) (Figs 2, 3, 5, 6). Although arterial hyperenhancement is a key diagnostic feature of nodular and massive HCC, infiltrative HCC may commonly appear as iso-or hypointense on images obtained during the arterial phase (33,34). Washout appearance is a specific CT and MR imaging feature of typical nodular HCC.…”

Section: Contrast-enhanced Ct and Mr Imagingmentioning

confidence: 97%

“…Portal vein tumor thrombosis is a common finding in patients with infiltrative HCC, often affecting both extra-and intrahepatic branches (10,13,17,(32)(33)(34), with a frequency ranging from 68% to 100%. Moreover, because of the permeative appearance and subtle enhancement of the tumor, portal vein thrombosis may appear as the primary imaging feature (33).…”

Section: Imaging Of Infiltrative Hccmentioning

confidence: 99%

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Infiltrative Hepatocellular Carcinoma: What Radiologists Need to Know

Reynolds¹,

Furlan²,

Fetzer³

et al. 2015

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Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide. The macroscopic growth pattern of HCC is subdivided into three categories: nodular, massive, and infiltrative. Infiltrative HCC accounts for 7%-20% of HCC cases and is confirmed at pathologic analysis on the basis of the spread of minute tumor nodules throughout large regions of the liver. Infiltrative HCC may represent a diagnostic challenge because it is often difficult to distinguish from background changes in cirrhosis at imaging. Infiltrative HCC usually spreads over multiple hepatic segments, occupying an entire hepatic lobe or the entire liver, and it is frequently associated with portal vein tumor thrombosis. The tumor is usually ill defined at ultrasonography and shows minimal and inconsistent arterial enhancement and heterogeneous washout at contrast material-enhanced computed tomography and magnetic resonance (MR) imaging. The tumor may be more visible among the surrounding liver parenchyma at diffusion-, T1-, and T2-weighted MR imaging. Several liver diseases can mimic the infiltrative appearance of this malignancy, including focal confluent fibrosis, hepatic fat deposition, hepatic microabscesses, intrahepatic cholangiocarcinoma, and diffuse metastatic disease (pseudocirrhosis). The prognosis for patients with infiltrative HCC is poor because the tumor is often markedly advanced and associated with vascular invasion at presentation. Survival after surgical resection is decreased; thus, infiltrative HCC is a contraindication for resection and transplantation. Knowledge of the key tumor characteristics and imaging findings will help radiologists formulate a correct and timely diagnosis to improve patient management.

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Section: Contrast-enhanced Ct and Mr Imagingmentioning

confidence: 97%

Section: Imaging Of Infiltrative Hccmentioning

confidence: 99%

Infiltrative Hepatocellular Carcinoma: What Radiologists Need to Know

Reynolds¹,

Furlan²,

Fetzer³

et al. 2015

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119

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“…Запу-щенные случаи ГЦР подразделяются в соответствии с их морфологией, а также -на инфильтративные и диффуз-ные. Многие параметры определяются при помощи МРТ [42]. Такие опухоли часто связаны с тромбозом воротной вены [43] или инвазией желчных протоков [44].…”

Section: обзор исторического развития шкал и классификаций при гцкunclassified

“…Интересно, что HAP не прошла валидизацию для ТАХЭ на мультицентрической европейской когорте [63]. Это был ожидаемый результат, так как исследовались случаи ГЦР > 70 мм, а эффективность лечения ТАХЭ основана на размере узла обычно < 50 мм [42,62]. Необходимы даль-нейшие исследования шкалы STATE, сфокусированной преимущественно на стадии В (BCLC).…”

Section: оценка гцр -«до первого лечения»unclassified

The problem of current classications of the hepatocellular carcinoma. Analytical review

Ротин¹,

Мороз²

2017

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“…Easy to calculate and well correlated to survival, it distinguishes 2 subgroups with different prognosis within BCLC stage C patients. Advanced HCC are classified according to their morphology as infiltrating or diffuse (hardly delimited lesion, with a heterogeneous enhancement, more easily characterized using magnetic resonance imaging [40] and frequently associated with portal vein thrombosis [41] or bile duct invasion), as opposed to the nodular HCC meeting the EASL/AASLD diagnosis criteria [42] . It also considers the AFP level (± 200 ng/mL), whose prognostic value has been demonstrated independently of the stage of the disease [4,10,43] ; those two last criteria missing from the BCLC system.…”

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confidence: 99%