Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment.

Area of Science:

• Hepatobiliary Medicine
• Surgical Oncology
• Diagnostic Imaging

Background:

• Spontaneously ruptured hepatocellular carcinoma (SRHCC) is a rare but life-threatening complication of hepatocellular carcinoma (HCC).
• SRHCC is associated with chronic liver disease, poor prognosis, and high acute-phase mortality.
• Clinical presentation often involves hemoperitoneum and acute abdominal pain, necessitating urgent diagnosis and treatment.

Purpose of the Study:

• To highlight the diagnostic significance of multi-phase contrast-enhanced CT (CECT) in SRHCC.
• To emphasize the importance of interpreting key CT findings for prompt diagnosis.
• To underscore the role of CECT in post-operative management and improving prognosis.

Main Methods:

• Review of clinical presentations and diagnostic imaging in SRHCC.
• Focus on multi-phase contrast-enhanced CT (CECT) as the primary diagnostic tool.
• Analysis of specific CT findings, including active contrast extravasation and the sentinel clot sign.

Main Results:

• Multi-phase CECT demonstrates high diagnostic accuracy and optimal temporal resolution for SRHCC.
• Key CT findings like active contrast extravasation and sentinel clot sign are fundamental for diagnosis.
• Trans-arterial (chemo)embolization (TAE/TACE) followed by hepatectomy shows improved long-term survival.

Conclusions:

• Multi-phase CECT is the diagnostic tool of choice for SRHCC, enabling immediate treatment decisions.
• Accurate interpretation of CT findings is critical for prompt diagnosis and intervention.
• Timely treatment guided by CECT significantly improves the prognosis of SRHCC patients.