Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, with typical imaging characteristics on contrast‐enhanced computed tomography (CECT). However, atypical variants pose a diagnostic challenge due to their unique morphological and enhancement patterns. This study evaluates the role of CECT in diagnosing atypical HCC presentations in a group of 20 patients, comprising 15 typical HCC cases and 5 atypical variants, including fibrolamellar HCC, diffuse infiltrating HCC, sarcomatous HCC and giant exophytic HCC. Statistical analysis was performed to compare enhancement patterns, tumor margins and associations with cirrhosis. The findings highlight the distinct imaging features of atypical HCCs and emphasize the importance of CECT in their evaluation. This retrospective observational study included 20 patients diagnosed with HCC using CECT. Of these, 15 cases exhibited typical HCC features, while 5 represented atypical variants. The study was conducted in the Department of Radiology at a tertiary care center over six months. Twenty known cases of hepatocellular carcinoma were imaged using a 128‐slice Siemens GoTop multidetector CT with a standardized protocol, including non‐contrast and contrast‐enhanced phases (arterial, venous, and delayed). Data on clinical presentations, CT findings and enhancement patterns were collected and analyzed. This study reveals that typical HCC patients were older (55.2 years vs. 47.6 years), predominantly male (12:3 vs. 3:2) and had a higher cirrhosis rate (86.7% vs. 40%) than atypical HCC patients. Imaging features showed arterial hyperenhancement (100% vs. 60%), washout on the delayed phase (93.3% vs. 40%) and capsular enhancement (80% vs. 20%) were more common in typical HCC, while tumor necrosis was higher in atypical HCC (60% vs. 26.7%). Atypical variants included fibrolamellar HCC (central scar), sarcomatous HCC (necrosis) and diffuse infiltrating HCC. Tumors were larger in atypical HCC (7.2 cm vs. 5.8 cm). These findings help differentiate typical from atypical HCC. CECT is highly effective in diagnosing, differentiating and characterizing typical and atypical hepatocellular carcinoma. It helps recognize unique imaging characteristics, aiding in early and accurate diagnosis and guiding therapeutic decisions.
How to cite this article:
P.S. Priyanka, Rohit and Sathish Babu. Role of Contrast‐Enhanced Computed Tomography (CECT) in Evaluating Atypical Presentations of Hepatocellular Carcinoma.
DOI: https://doi.org/10.36478/makrjms.2024.10.659.663
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2024.10.659.663