234
Imaging Features of Hepatocellular Carcinoma at First . .- Presentation in the Western Region of Saudi Arabia
Tarik M. AI-Baghdadi,
MSc. MRCPIUK);Asma A. AI-Dabbagh.
FRCR;Tarek R. Saleh.
MD;Hind A. EI-Deeb.
MD;Ahmed M. Mohalel.
MSc;Abdulrahman A. Mekkawi.
FRCS;Ossama A. Shobokshi.
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In a planned study. the ultrasonography (US) and computed tomography (CT) scans of 122 patients with biopsy proven hepatocellular carcinoma (HCC) were reviewed to determine the features of the tumour at first presentation and to compare the findings with those described in the literature to see if any differences exist. The right liver lobe was the most common site for the development of the tumour, which commonly showed an infiltrative (diffuse) pattern. Tumour size often exceeded 5 cm in diameter at presentation. On CT, prior to intravenous (Lv.) contrast injection, most tumours were slightly hypodense compared with the rest of the liver. The majority were better seen with rapid i.v. contrast infusion and showed peripheral and/or inhomogeneous contrast enhancement. Tumoural calcification was present in 14.8% of patients. On US the tumours were either hypoechoeic or had a mixed echo pattern. The echogenicity was found to increase in larger tumours. Vascular involvement by the tumour was assessed by both CT and US. The portal vein (PV) was more commonly involved than the inferior vena cava (IVC). Total occlusion of the PV was seen in 24.6% of patients. The IVC was occluded by tumour in 11.5% of patients. Radiologically detectable cirrhosis was often seen; and extrahepatic spread was not uncommon. The features of HCC from this region do not appear to differ from those described in the literature. But, the advanced stage of the tumour when first seen is probably more commonly seen owing to the absence of screening programmes.
Keywords: Hepatocellular carcinoma. Ultrasonography. Computed tomography.
Saudi Medical Journal 1994; 15(3): 234-238
From the Department of Diagnostic Imaging, King Abdulaziz University Hospital, PO Box 6615, Jeddah 21452, Saudi Arabia T. M. AL-BAGHDADI, A. A. AL-DABBAGH, T. R. SALEH, A. M. MOHALEL
From the Department of Surgery A. A. MEKKA WI From the Department of Medicine O. A. SHOBOKSHI
From the Department of Epidemiology, King Fahd General Hospital (MOH), Jeddah, Saudi Arabia H.A. EL-DEEB Received March, 1993. Revised September, 1993. Accepted for publication in final form October, 1993.
