Diagnostic and Interventional Radiology
Abdominal Imaging - Review

Hepatocellular carcinoma with macrovascular invasion: multimodality imaging features for the diagnosis

1.

Department of Radiology - BiND, University Hospital “Paolo Giaccone”, Palermo, Italy

2.

Department of Radiology, AP-HP, Hôpital Beaujon, Clichy, Hauts-de-Seine, France

3.

INSERM U1149 "centre de recherche sur l’inflammation", Université de Paris, Paris, France

4.

Department of Health Promotion, Division of Gastroenterology and Hepatology, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy

5.

Department of Radiology, Fondazione Istituto Giuseppe Giglio, Cefalù (Palermo), Italy

Diagn Interv Radiol 2020; 26: 531-540
DOI: 10.5152/dir.2020.19569
Read: 277 Downloads: 117 Published: 29 September 2020

Hepatocellular carcinoma (HCC) is frequently associated with macrovascular invasion of the portal vein or hepatic veins in advanced stages. The accurate diagnosis of macrovascular invasion and the differentiation from bland non-tumoral thrombus has significant clinical and management implications, since it narrows the therapeutic options and it represents a mandatory contraindication for liver resection or transplantation. The imaging diagnosis remains particularly challenging since the imaging features of HCC with macrovascular invasion may be subtle, especially in lesions showing infiltrative appearance. However, each radiologic imaging modality may provide findings suggesting the presence of tumor thrombus rather than bland thrombus. The purpose of this paper is to review the current guidelines and imaging appearance of HCC with macrovascular invasion. Knowledge of the most common imaging features of HCC with macrovascular invasion may improve the diagnostic confidence of tumor thrombus in clinical practice and help to guide patients’ management.

You may cite this article as: Cannella R, Taibbi A, Porrello G, Dioguardi Burgio M, Cabibbo G, Bartolotta TV. Hepatocellular carcinoma with macrovascular invasion: multimodality imaging features for the diagnosis. Diagn Interv Radiol 2020; 26:531–540

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