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Category: Volume 07 Issue 08 August 2019
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Title: Radiological Evaluation of Hepatocellular Carcinoma

Authors: Dr L.V.V. Prasad MD (RD), Dr Sri Lakshmi J P Rao G, Dr Y. Trinadh

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.38

Abstract

Introduction: Hepatocellular carcinoma is the fifth most common cancer worldwide and the second leading cause of cancer-related death. More than 7 lakh people die of HCC each year1,2. Imaging and histopathology plays a very important role in the diagnosis of HCC.

Materials & Methods: This s an observational study conducted over a period of one year, from September 2016 to October 2017 on 36 patients aged between 20-80yrs with sonologically detected hepatic mass lesions suspicious for HCC. They were evaluated with 16 slice CECT and 1.5T MRI. After taking informed consent, USG guided Biopsy/FNAC was done from these lesions and only those lesions that showed HCC were included in the study. The lesion characteristics are retrospectively analysed for the presence of specific features on US, CECT, MRI.

Results: Majority of the cases occurred in the age group of 51-60 years (38.88%), and there is a male preponderance (83.33%). Half the patients are cirrhotic (52.78%). Hepatomegaly is observed in 55.56% cases. 50% of the cases measured 5-10 cm in largest dimension. Majority of the lesions are hyperechoic and show intralesional vascularity. Majority of the lesions showed enhancement in the arterial phase of the CECT, followed by washout in the venous phase. Majority of them showed a well-defined capsule around the lesion, are hypointense on T1 and Hyperintense on T2, showing a mosaic architecture. Two thirds of the patients tested positive for Hepatitis B, deranged liver function tests and increased Alpha feto protein levels.

Conclusion: HCC can occur in a wide range of age groups. Though majority of the lesions show similar characteristics, HCC can have a wide spectrum of radiological appearances, and hence no single feature can be pathognomonic of the diagnosis. Hence, a tissue diagnosis is always desirable, whenever there is high index of suspicion, in lesions showing atypical pattern of imaging features.

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Corresponding Author

Dr L.V.V. Prasad MD (RD)

Department of Radio-Diagnosis, Andhra Medical College, Visakhapatnam, India