hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2020239-48hepato-656Research ArticleГЕПАТОЦЕЛЛЮРНЫЙ РАК. ДИАГНОСТИКА И ЛЕЧЕНИЕHEPATOCELLULAR CARCINOMA: DIAGNOSIS AND TREATMENTТрудности компьютерно-томографической диагностики гепатоцеллюлярного рака. Лекция и демонстрация наблюденийChallenges of hepatocellular cancer diagnosing in computed tomography. Lecture and demonstration of observationshttps://orcid.org/0000-0003-1742-7783РозенгаузЕ. В.RozengauzE. V.

Розенгауз Евгений Владимирович – доктор медицинских наук, главный научный сотрудник отдела лучевой диагностики ФГБУ РНЦРХТ имени академика А.М. Гранова МЗ РФ, профессор кафедры лучевой диагностики и лучевой терапии ФГБОУ ВО СЗГМУ им. И.И. Мечникова МЗ РФ

197758, Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 70, 

191015, Санкт-Петербург, ул. Кирочная, д. 41

Evgeny V. Rozengauz – Doct. of Sci. (Med.), Chief Researcher of the Department of Radiology, Granov Russian Scientific Center of Radiology and Surgical Technologies, Professor of the Department of Radiology and Radiation Therapy, North-Western State Medical University named after I. I. Mechnikov

70, Leningradskaya str., Pesochny, 197758, S.-Petersburg, 

41, Kirochnaya str., St. Petersburg, 191050

rozengaouz@yandex.ruhttps://orcid.org/0000-0002-1913-9390КарахановаА. Г.KarakhanovaA. G.

Караханова Анна Геннадьевна – врач-рентгенолог отделения рентгеновской компьютерной томографии

197758, Санкт-Петербург, пос. Песочный, д. 68

Anna G. Karakhanova – Radiologist of the Department of X-ray Computed Tomography

68, Leningradskaya str., Pesochny, St. Petersburg, 197758

annakarachanova@yandex.ruФГБУ “Российский научный центр радиологии и хирургических технологий имени академика А.М. Гранова” Минздрава РФ; ФГБОУ ВО “Северо-Западный государственный медицинский университет имени И.И. Мечникова” Минздрава РФРоссияGranov Russian Scientific Center of Radiology and Surgical Technologies; North-Western State Medical University named after I.I. MechnikovRussian FederationФГБУ “Национальный медицинский исследовательский центр онкологии имени Н.Н. Петрова” МЗ РФРоссияPetrov National Medical Research Center of OncologyRussian Federation2020180620202523948Copyright © Розенгауз Е.В., Караханова А.Г., 20202020Розенгауз Е.В., Караханова А.Г.Rozengauz E.V., Karakhanova A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/656

Гепатоцеллюлярный рак занимает особое место в ряду злокачественных опухолей, поскольку компьютернотомографическая или магнитно-резонансная картина позволяет с большой точностью диагностировать заболевание без биопсии. Это обстоятельство диктует необходимость тщательной оценки классического и атипичных вариантов изменений, выявляемых при лучевой диагностике. В работе проиллюстрированы различные варианты КТ-картины гепатоцеллюлярного рака.

Hepatocellular carcinoma has a special place among the malignant tumors, because the computed tomography or magnetic resonance picture allows to accurately disease diagnose without a biopsy. This circumstance calls for thorough assessment of the classical and atypical variants of changes detected during radiologic imaging. This paper illustrates various versions of the CT-scan picture of hepatocellular cancer. The various variants of a CT scan of hepatocellular carcinoma are illustrated in this publication.

печеньгепатоцеллюлярный раккомпьютерная томографияконтрастное усилениепаттерн контрастированияциррозпортальный тромбозliverhepatocellular carcinomacomputed tomographycontrast enhancementenhancement patterncirrhosisportal thrombosisReferencesChoi J.Y., Lee J.M., Sirlin C.B. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology. 2014; 272 (3): 635–654. https://doi.org/10.1148/radiol.14132361Choi J.Y., Lee J.M., Sirlin C.B. CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology. 2014; 272 (3): 635–654. https://doi.org/10.1148/radiol.14132361Кармазановский Г.Г. Роль МСКТ и МРТ в диагностике очаговых заболеваний печени. Анналы хирургической гепатологии. 2019; 24 (4): 91–110. https://doi.org/10.16931/1995-5464.2019491-110Karmazanovsky G.G. The role of MDCT and MRI in the diagnosis of focal liver diseases. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2019; 24 (4): 91–110. https://doi.org/10.16931/1995-5464.2019491-110 (In Russian)Roberts L.R., Sirlin C.B., Zaiem F., Almasri J., Prokop L.J., Heimbach J.K., Murad M.H., Mohammed K. Imaging for the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis. Hepatology. 2018; 67 (1): 401–421. https://doi.org/10.1002/hep.29487Roberts L.R., Sirlin C.B., Zaiem F., Almasri J., Prokop L.J., Heimbach J.K., Murad M.H., Mohammed K. Imaging for the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis. Hepatology. 2018; 67 (1): 401–421. https://doi.org/10.1002/hep.29487Bruix J., Sherman M., Llovet J.M., Beaugrand M., Lencioni R., Burroughs A.K., Christensen E., Pagliaro L., Colombo M., Rodés J. EASL Panel of Experts on HCC. Clinical management of hepatocellular carcinoma.Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J. Hepatol. 2001; 35 (3): 421–430. https://doi.org/10.1016/s0168-8278(01)00130-1Bruix J., Sherman M., Llovet J.M., Beaugrand M., Lencioni R., Burroughs A.K., Christensen E., Pagliaro L., Colombo M., Rodés J. EASL Panel of Experts on HCC. Clinical management of hepatocellular carcinoma.Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J. Hepatol. 2001; 35 (3): 421–430. https://doi.org/10.1016/s0168-8278(01)00130-1Lee J.H., Lee J.M., Kim S.J., Baek J.H., Yun S.H., Kim K.W., Han J.K., Choi B.I. Enhancement patterns of hepatocellular carcinomas on multiphasic multidetector row CT: comparison with pathological differentiation. Br. J. Radiol. 2012; 85 (1017): e573–e583. https://doi.org/10.1259/bjr/86767895Lee J.H., Lee J.M., Kim S.J., Baek J.H., Yun S.H., Kim K.W., Han J.K., Choi B.I. Enhancement patterns of hepatocellular carcinomas on multiphasic multidetector row CT: comparison with pathological differentiation. Br. J. Radiol. 2012; 85 (1017): e573–e583. https://doi.org/10.1259/bjr/86767895Туманова У.Н., Яшина Н.И., Кармазановский Г.Г., Щеголев А.И. Диагностические компьютерно-томографические критерии гепатоцеллюлярного рака разной степени дифференцировки в непораженной циррозом печени. Диагностическая и интервенционная радиология. 2015; 9 (1); 27–33.Tumanova U.N., Yachina N.I., Karmazanovsky G.G., Shchegolev A.I. Сomputed tomography diagnostic criteria of hepatocellular carcinoma with varying degree of differentiation in the liver unaffected by cirrhosis. Diagnostic and interventional radiology. 2015; 9 (1); 27–33. (In Russian)Розенгауз Е.В., Караханова А.Г., Нестеров Д.В. Особенности паттерна контрастирования гепатоцеллюлярного рака при тромбозе воротной вены. Медицинская визуализация. 2019; 23 (4): 68–75. doi.org/10.24835/1607-0763-2019-4-68-75Rozengauz E.V., Karakhanova A.G., Nesterov D.V. Contrast enhancement patterns of hepatocellular carcinoma with portal vein thrombosis. Medical Visualization. 2019; 23 (4): 68–75. https://doi.org/10.24835/1607-0763-2019-4-68-75 (In Russian)Lafitte M., Laurent V., Soyer P., Ayav A., Balaj C., Petit I., Hossu G. MDCT features of hepatocellular carcinoma (HCC) in non-cirrhotic liver. Diagn. Interv. Imaging. 2016; 97 (3): 355–360. http://dx.doi.org/10.1016/j.diii.2015.09.007.Lafitte M., Laurent V., Soyer P., Ayav A., Balaj C., Petit I., Hossu G. MDCT features of hepatocellular carcinoma (HCC) in non-cirrhotic liver. Diagn. Interv. Imaging. 2016; 97 (3): 355–360. http://dx.doi.org/10.1016/j.diii.2015.09.007.Basaran С., Karcaaltincaba M., Akata D., Karabulut N., Akinci D., Ozmen M., Akhan O. Fat-containing lesions of the liver: cross-sectional imaging findings with emphasis on MRI. AJR. Am. J. Roentgenol. 2005; 184: 1103–1110. https://doi.org/0361–803X/05/1844–1103Basaran С., Karcaaltincaba M., Akata D., Karabulut N., Akinci D., Ozmen M., Akhan O. Fat-containing lesions of the liver: cross-sectional imaging findings with emphasis on MRI. AJR. Am. J. Roentgenol. 2005; 184: 1103–1110. https://doi.org/0361–803X/05/1844–1103EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J. Hepatol. 2012; 56 (4): 908–943. https://doi.org/10.1016/j.jhep.2011.12.001.EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J. Hepatol. 2012; 56 (4): 908–943. https://doi.org/10.1016/j.jhep.2011.12.001.Luca A., Caruso S., Milazzo M., Mamone G., Marrone G., Miraglia R., Maruzzelli L., Carollo V., Minervini M.I., Vizzini G., Gruttadauria S., Gridelli B. Multidetector-row computed tomography (MDCT) for the diagnosis of hepatocellular carcinoma in cirrhotic candidates for liver transplantation: prevalence of radiological vascular patterns and histological correlation with liver explants. Eur. Radiol. 2010; 20 (4): 898–907. https://doi.org/10.1007/s00330-009-1622-0Luca A., Caruso S., Milazzo M., Mamone G., Marrone G., Miraglia R., Maruzzelli L., Carollo V., Minervini M.I., Vizzini G., Gruttadauria S., Gridelli B. Multidetector-row computed tomography (MDCT) for the diagnosis of hepatocellular carcinoma in cirrhotic candidates for liver transplantation: prevalence of radiological vascular patterns and histological correlation with liver explants. Eur. Radiol. 2010; 20 (4): 898–907. https://doi.org/10.1007/s00330-009-1622-0Kutami R., Nakashima Y., Nakashima O., Shiota K., Kojiro M. Pathomorphologic study on the mechanism of fat change in small hepatocellular carcinoma in humans. J. Hepatol. 2000; 33 (2): 282–289. https://doi.org/10.1016/s0168-8278(00)80369-4Kutami R., Nakashima Y., Nakashima O., Shiota K., Kojiro M. Pathomorphologic study on the mechanism of fat change in small hepatocellular carcinoma in humans. J. Hepatol. 2000; 33 (2): 282–289. https://doi.org/10.1016/s0168-8278(00)80369-4Umar N.K., Badshah M.B., Sandrasegaran K., Ghabril M., Agarwal S., Tann M., Lacerda M., Kwo P.Y. Thepresens of portal vein thrombosis alters the classic enhancement associated with diagnosis of hepatocellular carcinoma. Dig. Dis. Sci. 2015; 60 (7): 2196–2200. https://doi.org/10.1007/s10620-015-3587-y.Umar N.K., Badshah M.B., Sandrasegaran K., Ghabril M., Agarwal S., Tann M., Lacerda M., Kwo P.Y. Thepresens of portal vein thrombosis alters the classic enhancement associated with diagnosis of hepatocellular carcinoma. Dig. Dis. Sci. 2015; 60 (7): 2196–2200. https://doi.org/10.1007/s10620-015-3587-y.Kneuertz P.J., Demirjian A., Firoozmand A., CoronaVillalobos C., Bhagat N., Herman J., Cameron A., Gurakar A., Cosgrove D., Choti M.A., Geschwind J.F., Kamel I.R., Pawlik T.M. Diffuse infiltrative hepatocellular carcinoma: assessment of presentation, treatment, and outcomes. Ann. Surg. Oncol. 2012; 19 (9): 2897–2907. https://doi.org/10.1245/s10434-012-2336-0Kneuertz P.J., Demirjian A., Firoozmand A., CoronaVillalobos C., Bhagat N., Herman J., Cameron A., Gurakar A., Cosgrove D., Choti M.A., Geschwind J.F., Kamel I.R., Pawlik T.M. Diffuse infiltrative hepatocellular carcinoma: assessment of presentation, treatment, and outcomes. Ann. Surg. Oncol. 2012; 19 (9): 2897–2907. https://doi.org/10.1245/s10434-012-2336-0

The authors declare that there are no conflicts of interest present.