Nodular Lesions of Cirrhotic Liver: Imaging Manifestations with Pathologic Correlation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Bi , SONG Bin.

Department of Radiology,West China Hospital,Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Liver cirrhosis; Hepatocellular carcinoma; Magnetic resonance imaging; Xray computed tomography; Ultrasonography; Pathology

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ObjectiveTo introduce the new nomenclature scheme of the International Working Group (1995) on hepatic nodules, and summarize the imaging features of various hepatic nodules in light of their pathological characteristics, and evaluate the diagnostic values of various imaging facilities.MethodsUltrasound, computed tomography(CT), magnetic resonance imaging(MRI), and angiographic CT were reviewed and introduced.ResultsMany of these types of hepatic nodules play a role in the de novo and stepwise carcinogenesis of hepatocellular carcinoma(HCC) in the following steps: regenerative nodule, lowgrade dysplastic nodule, highgrade dysplastic nodule, small HCC, and large HCC. Accompanying such transformations, there are significant alterations in the blood supply and perfusion of these hepatic nodules.ConclusionModern stateoftheart medical imaging facilities can not only delineate and depict these hepatic nodules, but also provide important clues for the characterization of focal hepatic lesions in most cases, thus facilitating the early detection, diagnosis and management of HCC in its early stage.

Citation： WU Bi,SONG Bin.. Nodular Lesions of Cirrhotic Liver: Imaging Manifestations with Pathologic Correlation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(3): 288-294. doi: Copy

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1. International Working Party. Terminology of nodular hepatocellular lesions [J]. Hepatology, 1995; 22（3）∶ 983.
2. 周晓军. 肝脏交界性病变的病理组织学特点 [J]. 中华病理学杂志,2001； 30（3）∶ 222.
3. Krinsky G. Terminology of hepatocellular nodules in cirrhosis: plea for consistency [J]. Radiology, 2002; 224(3)∶ 638.
4. Hussain SM, Zondervan PE, IJzermans JN, et al. Benign versus malignant hepatic nodules: MR imaging findings with pathologic correlation [J]. Radiographics, 2002; 22(5)∶ 1023.
5. Choi BI. Hepatocarcinogenesis in liver cirrhosis: imaging diagnosis [J]. J Korean Med Sci, 1998; 13(2)∶ 103.
6. Lim JH,Choi BI. Dysplastic nodules in liver cirrhosis： imaging [J]. Abdom Imaging, 2002; 27(2)∶ 117.
7. Matsui O, Kadoya M, Kameyama T, et al. Benign and malignant nodules in cirrhotic livers: distinction based on blood supply [J]. Radiology, 1991; 178(2)∶ 493.
8. Matsui O, Ueda K, Kobayashi S, et al. Intra and perinodular hemodynamics of hepatocellular carcinoma: CT observation during intraarterial contrast injection [J]. Abdom Imaging, 2002; 27(2)∶ 147.
9. Hayashi M, Matsui O, Ueda K, et al. Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material [J]. Radiology, 2002; 225(1)∶ 143.
10. Roncalli M, Roz E，Coggi G, et al. The vascular profile of regenerative and dysplastic nodules of the cirrhotic liver: implications for diagnosis and classification [J]. Hepatology, 1999; 30(5)∶ 1174.
11. Horton KM, Bluemke DA, Hruban RH, et al. CT and MR imaging of benign hepatic and biliary tumors [J]. Radiographics, 1999; 19(2)∶ 431.
12. 李肃，徐坚民，单军. 肝局灶结节样增生MR、CT表现（附6例报告） [J]. 实用放射学杂志,2001； 17（4）∶ 281.
13. Mathieu D, Bruneton JN, Drouilard J, et al. Hepatic adenomas and focal nodular hyperplasia: dynamic CT study [J]. Radiology, 1986; 160(1)∶ 53.
14. Takayasu K, Furukawa H, Wakao F, et al. CT diagnosis of early hepatocellular carcinoma: sensitivity, findings, and CTpathologic correlation [J]. AJR Am J Roentgenol, 1995; 164(4)∶ 885.
15. Itoh Y, Akamatsu K. Relationships between echo lever and histological characteristics in small hepatocellular carcinomas [J]. J Clin Ultrasound, 1998; 26(6)∶ 295.
16. 李传福，刘松涛，马祥兴.螺旋CT多期增强扫描对小肝癌的诊断 [J]. 山东医科大学学报,2000； 38（4）∶ 403.
17. Zhou K,Yan F,Tu B. Evaluation of the arterial phase of biphasic enhanced SCT in the diagnosis of small HCC [J]. Zhonghua Ganzangbing Zazhi, 1999; 7(3)∶ 135.
18. 王薇.三种检查方法联合早期发现肝细胞癌的临床意义 [J]. 实用放射学杂志, 2000； 16（8）∶ 496.
19. Rode A,Bancel B,Douek P, et al. Small nodule detection in cirrhotic livers: evaluation with US, spiral CT, and MRI and correlation with pathologic examination of explanted liver [J]. J Comput Assist Tomogr, 2001; 25(3)∶ 327.
20. 杨海山，张宇，张惠茅.US、CT、MRI和DSA诊断原发性肝癌的比较研究 [J]. 中国医学影像学杂志, 2001； 9（1）∶ 70.
21. Murakami T, Kim T, Takahashi S, et al. Hepatocellular carcinoma: multidetector row helical CT [J]. Abdom Imaging, 2002; 27(2)∶ 139.
22. Yu JS,Kim MJ.Hepatocellular carcinoma: contrastenhanced MRI [J].Abdom Imaging, 2002; 27(2)∶ 157.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Nodular Lesions of Cirrhotic Liver: Imaging Manifestations with Pathologic Correlation

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