Diffuse HCC in a patient with chronic hepatitis C.
Coronal SS-FSE T2-WI (A), axial fat-suppressed SS-FSE
T2-WI (B), axial pre- (C) and postcontrast
fat-suppressed 3D-GRE T1-WI in the arterial (D) and
interstitial (E) phases, and coronal postcontrast
fat-suppressed 3D-GRE T1-WI in the interstitial phase
(F). A diffuse area of mild high-signal intensity
on T2-WI (asterisk, A,B) is depicted on the right liver
lobe, showing low-signal intensity on pre-contrast T1-WI
(C). On the dynamic postcontrast images, the lesion
is hypervascular at the arterial phase (D) and shows
delayed heterogeneous mottled washout (E,F). These
features are diagnostic of diffuse HCC. Note the tumor thrombus
filling and expanding the portal vein, typical of this type of HCC
(arrows, A–F). The thrombus shows hypervascular
characteristics and delayed washout comparable to the MRI dynamic
features of the tumor.