To evaluate the helical CT findings of ruptured hepatocellular carcinoma (H
CC), 12 patients with ruptured HCC were reviewed with regard to the tumour'
s location, size and contour protrusion, the appearance of the mass, the en
hancement pattern, multiplicity and secondary changes. AII ruptured tumours
were located at the periphery of the liver and had a protruding contour. T
he maximum diameter of tumours ranged from 2 cm to 16 cm. Discontinuity of
the hepatic surface was seen in 11 cases. In eight cases, CT images during
the arterial phase showed a non-enhancing low attenuating lesion with focal
discontinuity and peripheral rim enhancement. Seven cases showed separatio
n of tumour content from the peripheral enhancing rim and intraperitoneal r
upture of tumour content into the perihepatic space. Because of the similar
appearance to an enucleated orbital globe with remaining sclera, this was
termed the "enucleation sign". As well as ruptured masses, 10 cases with no
n-ruptured masses also showed a nonenhancing low attenuating pattern. Seven
cases showed a haematoma with high attenuation around the ruptured mass. T
he peripheral location, protruding contour, discontinuity of the hepatic su
rface and surrounding haematoma are helpful signs in the diagnosis of ruptu
red HCC. The "enucleation sign" may be a characteristic finding in ruptured
HCC.