Kovac JD, Milovanovic T, Dugalic V, Dumic I. Pearls and pitfalls in magnetic resonance imaging of hepatocellular carcinoma. World J Gastroenterol 2020; 26(17): 2012-2029 [PMID: 32536771 DOI: 10.3748/wjg.v26.i17.2012]
Corresponding Author of This Article
Jelena Djokic Kovac, MD, PhD, Professor, Departament of Radiology, Clinical Center Serbia, Pasterova 2, Belgrade 11000, Serbia. jelenadjokickovac@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 7, 2020; 26(17): 2012-2029 Published online May 7, 2020. doi: 10.3748/wjg.v26.i17.2012
Pearls and pitfalls in magnetic resonance imaging of hepatocellular carcinoma
Jelena Djokic Kovac, Tamara Milovanovic, Vladimir Dugalic, Igor Dumic
Jelena Djokic Kovac, Departament of Radiology, Clinical Center Serbia, Belgrade 11000, Serbia
Jelena Djokic Kovac, Tamara Milovanovic, Vladimir Dugalic, School of Medicine, Belgrade University, Belgrade 11000, Serbia
Tamara Milovanovic, Departament of Hepatology, Clinical Center Serbia, Belgrade 11000, Serbia
Vladimir Dugalic, Departament of Surgery, Clinical Center Serbia, Belgrade 11000, Serbia
Igor Dumic, Divison of Hospital Medicine, Mayo Clinic College of Medicine and Sciences, Mayo Clinic Health System, New York, NY 10029, United States
Author contributions: Kovac JD wrote the manuscript; Milovanovic T and Dugalic V collected the data; Dumic I contributed data and analysis tools.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jelena Djokic Kovac, MD, PhD, Professor, Departament of Radiology, Clinical Center Serbia, Pasterova 2, Belgrade 11000, Serbia. jelenadjokickovac@gmail.com
Received: December 31, 2019 Peer-review started: December 31, 2019 First decision: January 13, 2020 Revised: April 20, 2020 Accepted: April 24, 2020 Article in press: April 24, 2020 Published online: May 7, 2020 Processing time: 127 Days and 21 Hours
Core Tip
Core tip: The recognition of atypical presentations of hepatocellular carcinoma (HCC) is clinically important, since delay in the diagnosis can lead to inappropriate treatment of the patients. Due to multistep process of hepatocarcinogenesis, atypical vascular enhancement is frequently seen in smaller HCCs. Thus, hypovascular, and hypervascular lesions without washout in cirrhotic liver should raise suspicion of HCC. Additionally, HCC can be present in uncommon morphological patterns, such as diffuse, and infiltrative types. Fibrolamellar, steatotic, scirrhous HCC, and combined cholangiocarcinoma-HCC are rare histological types whose preoperative diagnosis is very challenging. This article reviews tips for differential diagnosis of uncommon HCCs and other liver lesions.
