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HCC: atypical with central scar

Case contributed by Dr Natalie Yang


Cirrhotic patient on follow up imaging

Modality: MRI

Selected MR images demonstrate heterogeneous enhancing lesion. Note that the peripheral components on the right side of the mass demonstrate more characteristic early arterial enhancement with washout, becoming hypointense c.f to the remainder of the liver. The central non-enhancing component remained non enhancing even in further delayed post contrast phases. 

Rim enhancement, which is more obvious in delayed images. 

Case Discussion:

Patient with hepatitis induced cirrhosis and an atypical HCC

The central scar, although bright on T2 does not demonstrate delayed enhancement, helping to distinguish this lesion from an FNH

Rim enhancement is also characteristic of HCC. 

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