Differentiation of Small Hepatic Hemangioma from Small Hepatocellular Carcinoma with Tri-Phasic Helical Computed Tomography Method

Muhammad Haseeb Jafar, Aruj latif, S Muhammad Yousaf Farooq, Hafiz Muhammad Rizwan, Muhammad Ahmad Raza, Muhammad Usama Sajid, Mubashir Hassan



Hepatocellular carcinoma (HCC) ranks second amongst all causes of cancer deaths globally. It is on a rise in Pakistan and might represent the most common cancer in adult males. Among women, HCC is the 7th most common cancer and 6th most common cancer related death. In Pakistan prevalence of HCC varies from 3.7%-16% of malignant tumors and most common cause of HCC is viral hepatitis B, C and D related cirrhosis. Pakistan contributes significantly to global burden of hepatitis C, which is a known risk factor for HCC, and has one of the highest prevalence rates (>3%) in the world.


To find out the difference of small hemangioma from small hepatic cellular carcinoma by using tri- phasic helical Computed Tomography method.


In this descriptive study, among 81 patients of suspected hepatocellular carcinoma and hepatocellular hemangioma were selected with age and gender discrimination by convenient sampling, at Department of Radiology, UOL Teaching hospital Lahore Pakistan. 128 slice Computed Tomography Toshiba Aquilion machine was used.


Out of 81 patients collected with the suspicion of hepatic hemangioma and hepatocellular carcinoma , 41 were females and 40 were males who visited radiology department. It shows 50.6% were females and males were 49.4%. Out of 81 patients, 25 patients came with HHS and 31 were with HCC. 25.9% develop carcinoma on left side, 32.1% on right side, 6.2% on R/L side and remaining 35.8% were Nill. Out of 81 patients 8 develop carcinoma on anterior, 5 on both, 3 on caudate, 5 on lateral,13 on both 4 on middle, 7 on posterior, 6 on segment eight, 1 on segment 4, 1 on segment 7, 1 on segment 2 and remaining 36 sites were nill. 27.5% males develop HCC and 48.8% females develop HCC. Out of 81 patients 36.6% female patients develop HHS and 25.0% male patients develop HHS.


In this study we conclude that females develop a large number of HCC and HHS than males. Hepatocellular carcinoma shows enhancement in early arterial and early washout phase while post-contrast images showing capsule-appearance which is relatively specific for HCC. On the other hand, HHS shows uniform enhancement in arterial phase and iso- or hyper-attenuating to liver parenchyma on delayed phase.

Keywords: Hepatocellular carcinoma, Hepatocellular hemangioma, Computed tomography

DOI: 10.7176/JHMN/73-07

Publication date: April 30th 2020

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ISSN 2422-8419

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