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British Journal of Radiology (2004) 77, 911-916
© 2004 British Institute of Radiology
doi: 10.1259/bjr/56713551
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Dysplastic nodules in liver cirrhosis: detection with triple phase helical dynamic CT

J H Lim, MD1, M J Kim, MD1, C K Park, MD2, S S Kang, MD1, W J Lee, MD1 and H K Lim, MD1

Departments of 1 Radiology and Center for Imaging Science and 2 Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul, Korea 135-710



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  		Figure 1. A 62-year-old woman with hepatitis B related cirrhosis who underwent right hepatic lobectomy for a hepatocellular carcinoma. Histopathological examination disclosed a 3.3 cm hepatocellular carcinoma (segment VIII) and eight low-grade dysplastic nodules measuring 5–11 mm. CT images on (a) arterial, (b) portal venous and (c) delayed phases shows an ill-defined, inhomogeneously enhancing hepatocellular carcinoma in the right hepatic lobe (segment VIII, large arrow) and a 5 mm low attenuating dysplastic nodule at the posterior part of the right lobe (segment VII, small arrow). The other seven dysplastic nodules were not depicted on CT. Note the heterogeneity of the hepatic parenchyma and the many small ill-defined nodules of subtle low attenuation representing cirrhotic regenerative nodules. Right and left hepatic bile ducts are dilated (arrowheads in b and c).

 


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  		Figure 2. A 64-year-old man with hepatitis B related liver cirrhosis who underwent right hepatic lobectomy for a hepatocellular carcinoma in the segment VI. A high-grade dysplastic nodule was confirmed in the segment VII. CT images at (a) arterial, (b) portal and (c) delayed phase imaging show a discrete, low attenuating nodule representing a dysplastic nodule (thick arrow) in the resected specimen. Thin arrow points to a large regenerative nodule.

 


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  		Figure 3. A 46-year-old man with hepatitis B related liver cirrhosis who underwent right hepatic lobectomy under the diagnosis of a suspected hepatocellular carcinoma in the segment VII. Histopathological examination disclosed a 14 mm low grade dysplastic nodule in the segment VII. CT images show an enhancing nodule (arrow) on (a) the hepatic arterial and (b) portal venous phases which is isoattenuating on (c) the delayed phase images; this represent the dysplastic nodule on histopathological examination.

 




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