Imaging Diagnosis

Riccardo Lencioni; Dania Cioni; Clotilde Della Pina; Laura Crocetti; Carlo Bartolozzi

doi:10.1055/s-2005-871196

Seminars in Liver Disease, Inhaltsverzeichnis

Semin Liver Dis 2005; 25(2): 162-170
DOI: 10.1055/s-2005-871196

Imaging Diagnosis

Riccardo Lencioni¹ ^, ² , Dania Cioni² , Clotilde Della Pina² , Laura Crocetti² , Carlo Bartolozzi²

¹Professor, Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy
²Division of Diagnostic and Interventional Radiology, Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Pisa, Italy

Abstract

ABSTRACT

The diagnosis of hepatocellular carcinoma (HCC) is based on imaging examinations in combination with clinical and laboratory findings. Despite technological advances, imaging cirrhotic patients remains a challenging issue because nonmalignant hepatocellular lesions, such as dysplastic nodules, mimic a small HCC. One of the key pathologic factors for differential diagnosis that is reflected in imaging appearances is the vascular supply to the lesion. It is accepted that imaging techniques may establish the diagnosis of HCC in nodules larger than 2 cm showing characteristic arterial hypervascularization. In lesions ranging from 1 to 2 cm, biopsy is still recommended, although a negative response can never be used to rule out malignancy completely. Although ultrasonography is widely accepted for HCC surveillance, spiral computed tomography (CT) or dynamic magnetic resonance imaging is required for diagnostic confirmation and intrahepatic tumor staging. These examinations have replaced invasive procedures, such as lipiodol CT, but remain relatively insensitive for the detection of tiny HCC lesions and tumor vascular invasion into peripheral portal vein branches.

KEYWORDS

Ultrasonography - computed tomography - magnetic resonance imaging - percutaneous biopsy

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Referenzen

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Prof.
Riccardo Lencioni

Division of Diagnostic and Interventional Radiology

Pisa University Hospital, Via Roma 67

I-56125 Pisa, Italy

eMail: Lencioni@do.med.unipi.it