Imaging of adenomatous hyperplastic lesions containing and not containing hepatocellular carcinoma in the liver

Abstract

In 41 patients with 54 lesions which were resected ans studied histopathologically, there were 14 lesions of adenomatous hyperplasias (AH) in 9 patients, 28 AHs containing hepatocellular carcinoma foci (early HCC, e-HCC) in 22 and 12 borderline lesions which fell between these two lesions in 10. The detectablity of these lesions on imagings was evaluated. Detection rates for all lesions and e-HCCs were as follows; intraoperative sonography, 70.0%, 87.5%; Portal-CT, 58.3%, 71.4%; sonography, 44.4%, 64.3%; Arterial-CT, 37.5%, 50.0%; CT, 32.7%, 57.7%; angiography, 17.0%, 30.8%; and Lipiodol-CT, 9.1%, 25.0%. On angiography, tumor stain was recognized in only 8 patients with e-HCC. Arterial-CT showed a relatively low density mass compared to non-tumorous area in 2 patients with e-HCC and one with borderline lesion. The median size of 54 lesions was 1.2±0.4cm indiameter and that of AHs was 0.8±0.3cm, the latter being significantly smaller than the other two lesions (p<0.01). Liver cirrhosis coexisted in 35 of 41 patients (85.4%). No complete necrosis occurred in 13 e-HCC lesions following therapeutic embolization or infusion chemotherapy in the hepatic artery.