IMAGING FEATURES OF HEPATOCELLULAR-CARCINOMA AT 1ST PRESENTATION IN THE WESTERN REGION OF SAUDI-ARABIA

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 p resentation and to compare the findings with those described in the li terature to see if any differences exist. The right liver lobe was the most common site for the development of the tumour, which commonly sh owed an infiltrative (diffuse) pattern. Tumour size often exceeded 5 c m in diameter at presentation. On CT, prior to intravenous (i.v.) cont rast injection, most tumours were slightly hypodense compared with the rest of the liver. The majority were better seen with rapid i.v. cont rast infusion and showed peripheral and/or inhomogeneous contrast enha ncement. Tumoural calcification was present in 14.8% of patients. On U S the tumours were either hypoechosic or had a mixed echo pattern. The echogenicity was found to increase in larger tumours. Vascular involv ement by the tumour was assessed by both CT and US. The portal vein (P V) 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 occlud ed by tumour in 11.5% of patients. Radiologically detectable cirrhosis was often seen; and extrahepatic spread was not uncommon. The feature s 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 s een is probably more commonly seen owing to the absence of screening p rogrammes.