Liver Masses / Hepatoma

What are the common liver masses?
What are the useful imaging modalities to investigate liver masses?
Utility of each procedure - Indicate when you would select each procedure.
Pathology of hepatoma (hepatocellular carcinoma):
What are the imaging findings of hepatoma?

CT

 

Multicentric hepatoma

Hepatoma with hemorrhage

  • NML is the normal liver density. White arrows point to increased density of the liver from hemorrhage (blood appears white on CT).
  • Black arrows point to the hepatoma. Note tiny calcification in the tumor.
  • Black arrows in the angiogram show the hypervascular tumor.

Hepatoma

Arrowheads point to the enhancing mass. Note the lobulated margins of the liver. Liver has lower density than spleen and ascites indicating underlying cirrhosis.

Hepatoma

  • Arrows: Tumor
  • Arrowheads: Tumor extends to portal vein
  • Portal veins dilated with intraluminal tumor. Portal veins in Liver appears dark on CT because it does not enhance with contrast.
 
MR Imaging

Hepatoma

MR shows a mass that has low signal intensity on T1 and high signal on T2.

Ultrasound
What are the imaging findings of liver cyst?
What are the imaging findings of liver metastases?

Liver metastasis

Multiple hypodense lesions seen in the liver with no significant contrast enhancement.

Primary: Colon carcinoma

 

Discuss the utility of imaging procedures for detection of liver metastases.