Diagnosis of 26 small hepatocellular carcinoma using incremental dynamic computed tomography

Kurume Med J. 1997;44(4):321-6. doi: 10.2739/kurumemedj.44.321.

Abstract

Hepatocellular carcinoma (HCC) is usually visualized as high density area in early phase of an incremental dynamic computed tomography (ID-CT). Small HCC nodules less than 2 cm in diameter are sometimes, however, showing no contrast enhancement. We examined 26 HCC nodules less than 2 cm in diameter by ID-CT. All HCC nodules examined were originally detected by ultrasonography and diagnosed by fine needle biopsy in histology. We studied the sensitivity of ID-CT in detecting HCC nodules and a possible association between a presence or absence of contrast enhancement and the degree of cell differentiation of HCC nodules. Of the 26 HCC nodules, 22 (84.6%) were detected by ID-CT. Of the 22 detected nodules, 7 were depicted as high density area in early phase of ID-CT, and 5 were moderately differentiated HCC and the other 2 were poorly differentiated HCC in histology. Twelve nodules were low density area in early phase of ID-CT, and all of them were well-differentiated HCC. The other 3 nodules, which were isodense in early phase, were depicted as low density area in late phase, and 2 were well-differentiated HCC and other was moderately differentiated HCC. In this study, most of small and well-differentiated HCC nodules less than 2 cm in diameter showed no contrast enhancement in early phase of ID-CT. Therefore, when ID-CT of intrahepatic nodules less than 2 cm shows low density in early phase without contrast enhancement, well-differentiated HCC are most suspected, and further examinations such as magnetic resonance imaging and needle biopsy are needed.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Female
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed*