Early hepatocellular carcinoma: MR imaging

All areas in hepatic lesions designated as adenomatous hyperplasia (AH) with malignant foci have recently been recognized as cancer. AH with malignant foci can be classified into two types, depending on the presence of overt cancerous nodules. Lesions without macroscopic nodules are defined as early hepatocellular carcinoma (HCC), while those with a macroscopic component are defined as HCC with early components. A comparative study of early HCC and HCC with early components was performed with magnetic resonance imaging. Early HCC lesions (n = 20) were isointense (n = 11) and hyperintense (n = 9) on T1-weighted spin-echo images and isointense (n = 17), partially hyperintense (n = 2), or hypointense (n = 1) on T2-weighted spin-echo images relative to the surrounding liver. Lesions classified as HCC with early components (n = 8) were hyperintense (n = 5), isointense (n = 2), and of mixed signal intensity (n = 1) on T2-weighted images. T1-weighted imaging was superior to T2-weighted imaging in depicting early HCC, but the latter could be useful in evaluating the progression of HCC in the histopathologically early stages.