Case 344:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

64 year old man with history of chronic hepatitis C.

MR: Typical, with washout and pseudocapsule

Imaging Findings:

MR shows an arterially enhancing HCC in segment 5, corresponding to the vague area of enhancement on the CT. It shows the typical washout and a pseudocapsule on the portal venous and equilibrium phase. Compare to CT, which only showed subtle washout on the portal venous phase CT. The central hypointense area seen on portal venous phase shows subtle hypointensity also on equilibrium phase, surrounded by a subtle progressively enhancing ring, typical for a fibrotic component (scar) surrounding a small area of necrosis. Note mild hyperintensity of the entire mass on T2w, which is also typical for HCC.