Imaging of early hepatocellular carcinoma and adenomatous hyperplasia (dysplastic nodules) with dynamic CT and a combination of CT and angiography: Experience with resected liver specimens

Kenichi Takayasu, Yukio Muramatsu, Yasunori Mizuguchi, Noriyuki Moriyama, Hidenori Ojima

Research output: Contribution to journalReview article

34 Citations (Scopus)


Early hepatocellular carcinoma (HCC) as defined by the Liver Cancer Study Group of Japan would correspond to high-grade dysplastic nodules with small foci of HCC in the majority of cases, using the classification system proposed by the International Working Party. A large number of early HCCs were revealed to be hypo- or isovascular in the arterial phase of dynamic CT. Only 5% of the lesions evaluated were hypervascular, which contrasted with advanced small HCCs, of which 94% were hypervascular. CT arterial portography (CTAP) showed hypoattenuation in 66% of early HCCs and isoattenuation in 34%. CT hepatic arteriography (CTHA) demonstrated hypoattenuation in 55% of early HCC, isoattenuation in 30% and hyperattenuation in 15%. These findings suggest that most early HCCs receive equal or reduced blood supply from both portal and arterial flow compared with surrounding noncancerous parenchyma. In contrast, 97% of small HCCs are hypoattenuated on CTAP, and 93% are hyperattenuated on CTHA. For nodule-in-nodule type HCC (advanced HCC within early HCC), the CT attenuation of the central and peripheral portions revealed areas of isolated advanced HCC and isolated early HCC, respectively. Adenomatous hyperplasia (low-grade dysplastic nodules) was not readily differentiated using the various imaging modalities, mainly due to the smaller size of these lesions compared to early HCC and/or a portal and arterial blood supply very similar to that of the surrounding parenchyma. Hemodynamic changes in cirrhotic liver were similarly evaluated using CTAP and CTHA, and the treatment of early HCC is briefly discussed herein.

Original languageEnglish
Pages (from-to)199-208
Number of pages10
Issue number3-5
Publication statusPublished - 2004 Oct 7
Externally publishedYes



  • Adenomatous hyperplasia (dysplastic nodules)
  • CT
  • Combination of CT and angiography
  • Early hepatocellular carcinoma

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

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