Which imaging feature favors hepatocellular carcinoma over a benign hemangioma on triphasic CT?

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Multiple Choice

Which imaging feature favors hepatocellular carcinoma over a benign hemangioma on triphasic CT?

On triphasic CT, hepatocellular carcinoma typically shows arterial phase hyperenhancement due to its arterial blood supply, followed by washout in the portal venous or delayed phases when the lesion becomes hypoattenuating relative to the surrounding liver. This pattern—arterial enhancement with venous washout—is the hallmark that helps distinguish HCC from a benign hemangioma. Benign hemangiomas, in contrast, usually display peripheral nodular enhancement in the arterial phase with progressive centripetal fill-in on delayed phases and do not exhibit washout. Central scar is more typical of focal nodular hyperplasia, and homogeneous enhancement in all phases is not characteristic of HCC.

On triphasic CT, hepatocellular carcinoma typically shows arterial phase hyperenhancement due to its arterial blood supply, followed by washout in the portal venous or delayed phases when the lesion becomes hypoattenuating relative to the surrounding liver. This pattern—arterial enhancement with venous washout—is the hallmark that helps distinguish HCC from a benign hemangioma. Benign hemangiomas, in contrast, usually display peripheral nodular enhancement in the arterial phase with progressive centripetal fill-in on delayed phases and do not exhibit washout. Central scar is more typical of focal nodular hyperplasia, and homogeneous enhancement in all phases is not characteristic of HCC.

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