Atypical magnetic resonance imaging features and differential diagnosis of hepatocellular carcinoma.
OBJECTIVE
Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. We aimed to summarize and analyze the atypical magnetic resonance imaging (MRI) features of HCC to improve its diagnostic accuracy.


METHODS
We retrospectively analyzed MRI data for 66 patients with HCC with atypical MRI features confirmed by operation and pathology.


RESULTS
Twelve patients had high signals and 18 patients had significant decreases in opposed phase signals in T1WI plain scans. Nine patients had high signals and six patients had large cystic lesions in apparent diffusion coefficient images. Dynamic enhancement showed progressive enhancement in 15 patients, ring enhancement in three, irregular patchy enhancement in three, 'nodule-in-nodule' enhancement in six, delayed central patchy enhancement in six, delayed central 'star-like aristate scars' (T2WI revealed high signal intensity) in 21, and poor blood supply in three patients.


CONCLUSIONS
MRI can make a clear diagnosis of typical HCC, and atypical cases can also be distinguished from other tumors or tumor-like lesions by MRI. The analysis of atypical signs may improve the diagnostic accuracy of MRI for HCC.
['Wang|Shuang-Yu|SY|', 'Yin|Lei|L|', 'Wang|Chen|C|', 'Ma|Ming-Ping|MP|https://orcid.org/0000-0003-3638-3472']
D006528:Carcinoma, Hepatocellular D003287:Contrast Media D003937:Diagnosis, Differential D006801:Humans D008113:Liver Neoplasms D008279:Magnetic Resonance Imaging D012189:Retrospective Studies
atypical magnetic resonance imaging differential diagnosis Hepatocellular carcinoma enhancement pathological section