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Enhancement patterns and signal-intensity characteristics of small hepatocellular carcinoma in cirrhosis: pathologic basis and diagnostic challenges

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An Erratum to this article was published on 21 September 2007

Abstract

Recent pathologic studies of hepatic resection and transplantation specimens have elucidated the morphologic features of the precancerous lesions and small hepatocellular carcinomas (HCCs) arising in cirrhotic livers. Small HCCs measuring less than 2 cm in diameter are of two types: vaguely nodular, well-differentiated tumors, also known as “early” HCCs, and distinctly nodular tumors, with histologic features of “classic” HCC. The precancerous lesions include dysplastic foci and dysplastic nodules. “Classic” small HCCs are supplied by nontriadal arteries, whereas early HCCs and dysplastic nodules may receive blood supply from both portal tracts and nontriadal arteries. The similarities in blood supply of these three types of nodular lesions result in significant overlap of findings on dynamic imaging. Nevertheless, small HCCs sometimes display characteristic radiologic features, such as “nodule-in-nodule” configuration and “corona enhancement” pattern. Moreover, various histologic features of these nodular lesions may also be related to a variety of signal intensities and attenuation coefficients, while the presence of cirrhosis is known to limit the sensitivity and specificity of any imaging modality, due to liver inhomogeneity. Because of these reasons, imaging findings of nodular lesions in cirrhotic livers are often inconclusive, emphasizing the need for a better understanding of these imaging features.

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Authors and Affiliations

  1. Department of Radiology, University of Ioannina Medical School, P.O. Box 1186, 45110, Ioannina, Greece

    Stavros C. Efremidis

  2. Department of Pathology, Aristotle University of Thessaloniki Medical School, 54006, Thessaloniki, Greece

    Prodromos Hytiroglou

  3. Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, 920-8641, Japan

    Osamu Matsui

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  1. Stavros C. Efremidis
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  2. Prodromos Hytiroglou
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  3. Osamu Matsui
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Correspondence to Stavros C. Efremidis.

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An erratum to this article can be found at http://dx.doi.org/10.1007/s00330-007-0765-0

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Efremidis, S.C., Hytiroglou, P. & Matsui, O. Enhancement patterns and signal-intensity characteristics of small hepatocellular carcinoma in cirrhosis: pathologic basis and diagnostic challenges. Eur Radiol 17, 2969–2982 (2007). https://doi.org/10.1007/s00330-007-0705-z

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