Imaging features of scirrhous hepatocellular carcinomas

Abstract

Objective To investigate CT and MR features of scirrhous hepatocellular carcinomas (SHCC).Methods Imaging findings of 32 patients with SHCC confirmed by liver biopsy or hepatic surgery were retrospectively reviewed.CT scan was performed in 30 cases and MR scan was performed in 2 cases.Mann-Whitney U test was used to compare the diameters of the tumors in patients with or without abnormal alpha fetoprotein(AFP)testing results.Results The tumors manifested as heterogeneous hypodense masses with well-or ill-defined margin on non-enhanced CT images.The appearances of SHCC on dynamic enhanced CT images were divided into 3 types.(1) Rim enhancement in the arterial phase,followed by progressively centripetal enhancement during portal venous and equilibrium phases (n =13).(2) No enhancement or heterogeneous enhancement in the arterial phase,peripheral enhancement and septal enhancement in the delayed phase (n =15).(3)Heterogeneous mild enhancement in the early phase and wash-out quickly in the portal venous and equilibrium phases showing homogeneous hypodense (n =2).Two patients underwent MRI examination,and the tumors showed homogeneous hypointensity on T1WI images and heterogeneous hyperintensity on T2WI images.On dynamic enhanced MRI,the tumors showed rim enhancement in the arterial phase,followed by progressively centripetal enhancement during portal venous and equilibrium phases,which was similar to type 1 of enhanced CT.AFP values were normal in 8 cases,in which the media diameter of tumors was 53.5 mm(13.0 to 124.0 mm).AFP values were abnormal in 24 cases,in which the media diameter of tumors was 70.7 mm(16.0 to 167.0 mm).There was no significant difference between the two groups(Z =-1.176,P =0.239).Histopathology revealed exuberant interfibrillar substance in the tumors of all 32 patients.Conclusion SHCC may present characteristic progressively centripetal enhancement,or similar imaging features to typical nodular hepatocellular carcinoma. Key words: Liver neoplasms ; Tomography,X-ray computed ; Magnetic resonance imaging