Abstract
The sensitivity, specificity, and accuracy of ultrasonography (US), dynamic incremented computed tomography (CT) with delayed phase imaging, and magnetic resonance imaging (MRI) with or without Gd-DTPA were studied for detecting the characteristic appearances of hepatocellular carcinomas (HCC): fibrous capsules, fibrous septa, and mosaic appearances. Results were prospectively evaluated in 30 patients who subsequently underwent hepatic lobectomies or segmentectomies. Pathologic evaluations of the resected liver specimens demonstrated fibrous capsules in 20 tumors (66.7%), fibrous septa in 13 tumors (43.3%), and mosaic appearances in 19 tumors (63.3%). The accuracies for fibrous capsules were 71.4% (20 of 28) for US, 81.5% (22 of 27) for CT, and 92.3% (24 of 26) for MRI. The accuracies for fibrous septa were 57.1% (16 of 28) for US, 59.3% (16 of 27) for CT, and 73.1% (19 of 26) for MRI. The accuracies for mosaic appearances were 71.4% (20 of 28) for US, 51.9% (14 of 27) for CT, and 69.2% (18 of 26) for MRI. Gd-DTPA administrated MRI showed higher accuracies than did conventional MRI for all manifestations. In conclusion, the fibrous capsules of HCCs were readily detected by CT and MRI. Gd-DTPA administration demonstrated an advantage in clarifying fibrous capsules, as well as fibrous septa and mosaic appearances.
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Nakashima T, Kojiro M, Sakamoto K, Okuda K, Shimokawa Y, Kudo Y. Studies of primary liver carcinoma. I. Proposal of new gross anatomical classification of primary liver cell carcinoma.Acta Hepatol Jpn 1974;15:279–291
Shimokawa Y, Kubo Y, Arishima T et al. Studies of primary liver carcinoma. III. Clinicopathological characteristics of gross anatomy of hepatocellular carcinoma according to the Nakashima-Okuda's classification.Acta Hepatol Jpn 1975;16:752–762
Okuda K, Obata H, Shigenobu J et al. Angiographic assessment of gross anatomy of hepatocellular carcinoma: comparison of celiac angiograms and liver pathology in 100 cases.Radiology 1977;123:21–29
Okuda K, Musha H, Nakajima J et al. Clinicopathologic features of encapsulated hepatocellular carcinoma: a study of 26 cases.Cancer 1977;40:1240–1245
Ros PR, Murphy BJ, Buck JL, Olmedilla G, Goodman Z. Encapsulated hepatocellular carcinoma: radiologic findings and pathologic correlation.Gastrointest Radiol 1990;15:233–237
Rummeny E, Weissleder R, Stark DD et al. Primary liver tumors: diagnosis by MR imaging.AJR 1989;152:63–72
Kojiro M, Nakashima T. Pathology of hepatocellular carcinoma In: Okuda K Ishak KG eds.Neoplasms of the liver. Tokyo: Springer-Verlag, 1987:81–104
Tanaka N, Okamoto E, Toyosaka A, Fujiwara S. Pathological evaluation of hepatic dearterialization in encapsulated hepatocellular carcinoma.J Surg Oncol 1985;29:256–260
Okabe M. Patho-morphological studies on hepatocellular carcinoma: a study on a mechanism of capsule formation of tumor nodule.Acta Hepatol Jpn 1979;20:144–156
Nakashima O. Pathomorphological study on early hepatocellular carcinoma: a study of capsule and septum formation.Acta Hepatol Jpn 1989;30:28–34
Ebara M, Ohto M, Watanabe Y et al. Diagnosis of small hepatocellular carcinoma: correlation of MR imaging and tumor histologic studies.Radiology 1986;159:371–377
Kenmochi K, Sugihara S, Kojiro M. Relationship of histologic grade of hepatocellular carcinoma (HCC) to tumor size, and demonstration of tumor cells of multiple different grades in single small HCC.Liver 1987;7:18–26
Choi BI, Lee GK, Kim ST, Han MC. Mosaic pattern of encapsulated hepatocellular carcinoma: correlation of magnetic resonance imaging and pathology.Gastrointest Radiol 1990;15:238–240
Takayasu K, Shima Y, Muramatsu Y et al. Angiography of small hepatocellular carcinomas: analysis of 105 resected tumors.AJR 1986;147:525–529
Yoshimatsu S, Inoue Y, Ibukuro K, Suzuki S. Hypovascular hepatocellular carcinoma undetected at angiography and CT with iodized oil.Radiology 1989;171:343–347
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Honda, H., Onitsuka, H., Murakami, J. et al. Characteristic findings of hepatocellular carcinoma: An evaluation with comparative study of US, CT, and MRI. Gastrointest Radiol 17, 245–249 (1992). https://doi.org/10.1007/BF01888559
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DOI: https://doi.org/10.1007/BF01888559