Hepatocellular adenoma CT: Difference between revisions

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==CT==
==CT==
 
* The CT scan appearances of hepatocellular adenoma are usually variable, and classical characteristic lesions of adenoma are best seen with multi-phase helical CT scan.
* [[Fat]] or [[hemorrhage]] can easily be identified on unenhanced images, and delayed-phase images demonstrate the tendency for fibrotic components to enhance and retain contrast material.
* The CT scan findings of hepatocellular carcinoma include;
 
** Non lobulated, well marginated mass that can be encapsulated and is rarely calcified.
* Because [[adenoma]]s consist almost entirely of uniform [[hepatocyte]]s and a variable number of [[Kupffer cell]]s, most [[adenoma]]s are nearly isoattenuating relative to normal liver on unenhanced, portal venous–phase, and delayed-phase images.
** Homogeneous enhancement in the arterial phase. It is usually isoattenuating but sometimes mildly hypoattenuating relative to normal liver on un enhanced portal venous phase and delayed phase images.
 
** The presence of intratumoral fat can show a hypoattenuating mass, if it is surrounded by a fatty liver it appears hyperattenuating on all contrast phases and unenhanced images.
* In patients with [[fatty liver]], adenomas are hyperattenuating at all phases of contrast enhancement and on unenhanced images as well.
** A heterogenous, hypoattenuating area within the tumor is seen in necrosis or old hemorrhage.
 
** The larger hepatocellular adenomas may be more heterogeneous than smaller lesions and their CT scan appearance is less specific.
* Small hepatocellular adenomas enhance rapidly and are hyperattenuating relative to the liver.
 
* Excluding lesions with acute or old tumor hemorrhage and fat deposition, hepatocellular adenoma demonstrated homogeneous or nearly homogeneous enhancement in approx 80% of cases.
 
:* The enhancement usually does not persist in adenomas because of arteriovenous shunting.
 
* Larger hepatocellular adenomas may be more heterogeneous than smaller lesions, and their [[CT]] appearance is less specific.


==References==
==References==

Revision as of 07:08, 7 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

CT

  • The CT scan appearances of hepatocellular adenoma are usually variable, and classical characteristic lesions of adenoma are best seen with multi-phase helical CT scan.
  • The CT scan findings of hepatocellular carcinoma include;
    • Non lobulated, well marginated mass that can be encapsulated and is rarely calcified.
    • Homogeneous enhancement in the arterial phase. It is usually isoattenuating but sometimes mildly hypoattenuating relative to normal liver on un enhanced portal venous phase and delayed phase images.
    • The presence of intratumoral fat can show a hypoattenuating mass, if it is surrounded by a fatty liver it appears hyperattenuating on all contrast phases and unenhanced images.
    • A heterogenous, hypoattenuating area within the tumor is seen in necrosis or old hemorrhage.
    • The larger hepatocellular adenomas may be more heterogeneous than smaller lesions and their CT scan appearance is less specific.

References


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