Lee Jeong Min, Yoon Jeong-Hee, Joo Ijin, Woo Hyun Sik
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.
Liver Cancer. 2012 Jun;1(1):22-40. doi: 10.1159/000339018.
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Accurate diagnosis and assessment of disease extent are crucial for proper management of patients with HCC. Imaging plays a crucial role in early detection, accurate staging, and the planning of management strategies. A variety of imaging modalities are currently used in evaluating patients with suspected HCC; these include ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, and angiography. Among these modalities, dynamic MRI and CT are regarded as the best imaging techniques available for the noninvasive diagnosis of HCC. Recent improvements in CT and MRI technology have made noninvasive and reliable diagnostic assessment of hepatocellular nodules possible in the cirrhotic liver, and biopsy is frequently not required prior to treatment. Until now, the major challenge for radiologists in imaging cirrhosis has been the characterization of small cirrhotic nodules smaller than 2 cm in diameter. Further technological advancement will undoubtedly have a major impact on liver tumor imaging. The increased speed of data acquisition in CT and MRI has allowed improvements in both spatial and temporal resolution, which have made possible a more precise evaluation of the hemodynamics of liver nodules. Furthermore, the development of new, tissue-specific contrast agents such as gadoxetic acid has improved HCC detection on MRI. In this review, we discuss the role of CT and MRI in the diagnosis and staging of HCC, recent technological advances, and the strengths and limitations of these imaging modalities.
肝细胞癌（HCC）是全球最常见的恶性肿瘤之一。准确诊断和评估疾病范围对于HCC患者的合理管理至关重要。影像学在早期检测、准确分期以及管理策略的规划中起着关键作用。目前，多种影像学检查方法用于评估疑似HCC的患者；这些方法包括超声、计算机断层扫描（CT）、磁共振成像（MRI）、核医学和血管造影。在这些检查方法中，动态MRI和CT被认为是用于HCC无创诊断的最佳影像学技术。CT和MRI技术的最新进展使得对肝硬化肝脏中的肝细胞结节进行无创且可靠的诊断评估成为可能，并且在治疗前通常无需进行活检。到目前为止，放射科医生在肝硬化影像学检查中的主要挑战一直是对直径小于2 cm的小肝硬化结节进行特征性描述。进一步的技术进步无疑将对肝脏肿瘤影像学产生重大影响。CT和MRI数据采集速度的提高使得空间和时间分辨率都得到了改善，从而能够更精确地评估肝脏结节的血流动力学。此外，新型组织特异性造影剂如钆塞酸的开发提高了MRI对HCC的检测能力。在本综述中，我们讨论了CT和MRI在HCC诊断和分期中的作用、最近的技术进展以及这些影像学检查方法的优缺点。
