Notes for residents---A patient of alcoholic disease with raised alfa foetoprotein (can be more than 1000 ng/ml in 50% cases) and FNAC postive HCC. Features include capsule formation, presence of fat, suppressed on out of phase GRE images, no definite portal venous or hepatic venous invasion, No MR demonstrable calcification or biliary dilatation.Color doppler showed plenty of vascularity with increased diastolic flow.More common in males (7 to 8 times) more in 30-60 yrs. Contrast study would show increased early arterial enhancement, No significant contrast on equilibrium stage or hepatobiliary phase (1 hour) because hepatocytes are unable to excrete gadolinium in to bile and show it. Another feature would be peripheral washout in portal venous pahse. Pseudocapsule can enhance in portal venous phase. Case submitted by Dr MGK Murthy Sr Consultant Teleradiology Providers
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