Premium
Diagnosis of small hepatocellular carcinoma by computed tomography: Correlation of CT findings and histopathology
Author(s) -
TSUNETOMI SHIGEYUKI,
OHTO MASAO,
IINO YASUO,
SHINAGAWA TAKASHI,
KIMURA KUNIO,
MORITA MASAHIRO,
SAISHO HIROMITSU,
TSUCHIYA YUKIHIRO,
HIROOKA NOBORU,
OKUDA KUNIO
Publication year - 1989
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1989.tb01736.x
Subject(s) - medicine , hepatocellular carcinoma , radiology , computed tomography , histopathology , tomography , carcinoma , nuclear medicine , pathology
The diagnostic value of computed tomography (CT) scans in small hepatocellular carcinoma (HCC) (<5 cm) was studied in 82 patients. Dynamic scan was also made in 66 of them. Combined unenhanced and enhanced scans detected 87% of the lesions > 2 cm, but the detection rate was only 25% for lesions <1.5 cm. Diagnostic failure was due to isodensity of the mass and to technical artefacts. Diagnosis of the surrounding capsule and internal septa (partition) and demonstration of the typical pattern of density enhancement by dynamic scan proved useful in differentiating HCC from secondary cancers. On unenhanced CT, the density of the interior was subject to the histological changes of tumour such as bleeding, necrosis and fatty metamorphosis. Similarly, enhanced CT showed density changes suggestive of these histological changes. Dynamic scan proved particularly useful for lesions <3 cm because the typical density enhancement was frequently demonstrated in the arterial phase. It was concluded that unenhanced CT combined with dynamic scan has a high diagnostic value in small HCC and reflects histological changes.