Benign and malignant mimickers of infiltrative hepatocellular carcinoma: tips and tricks for differential diagnosis on CT and MRI

Abstract Hepatocellular carcinoma (HCC) may have an infiltrative appearance in about 8–20% of cases. Infiltrative HCC can be a challenging diagnosis and it is associated with the worst overall survival among patients. characterized by spread multiple minute nodules throughout liver, without dominant one, ultimately resulting into macrovascular invasion. On CT MRI, appears as ill-defined, large mass, variable degree enhancement, satellite neoplastic up to 52% show restriction on diffusion weighted imaging, hyperintensity T2- hypointensity T1-weighted images, and, if hepatobiliary agent used, phase. must differentiated from other liver diseases, such focal confluent fibrosis, steatosis, amyloidosis, vascular disorders cholangiocarcinoma, diffuse metastatic disease. In cirrhotic patients, identification tumor invasion portal vein its differentiation bland thrombosis utmost importance for patient management. contrast enhanced enhancing thrombus within vein, close main results enlargement. The aim this pictorial review MRI features that allow thrombosis. A particular point interest includes tips tricks differential potential mimickers HCC.