What are the causes for increased hepatic attenuation on CT?
Deposition of metals (haemochromatosis, haemosiderosis, Wilson disease), glycogen storage disease, amiodarone, gold, and thorotrast.
The patient was referred for urgent 4-phase liver because of suspected hepatocellular carcinoma.
On non-contrast CT, the liver is of diffusely increased density. The hepatic vasculature and biliary tree appear conspicuous due to their relative hypodensity. The density of the spleen and pancreas appear normal. The lesion seen on ultrasound appears as a mass hypodense relative to liver parenchyma.
The mass in segment VIII demonstrates peripheral nodular enhancement on arterial phase. Portal and hepatic veins remain conspicuous against hyperdense liver parenchyma. There is a progressive centripetal enhancement of the mass until complete fill-in on 5-minute delayed phase, where the liver is now of homogeneous attenuation.