title: Diagnosing Borderline Hepatic Nodules in Hepatocarcinogenesis: Imaging Performance.
abstract: OBJECTIVE
  The purposes of this article are to describe the pathologic and radiologic features of small nodular lesions and to offer insight into the multistep process of hepatocarcinogenesis by describing the progression of imaging changes that link dysplastic nodules and early hepatocellular carcinoma, (HCC) to small HCC that has progressed.
  
  
  CONCLUSIONS
  Nodules larger than 1 cm found during ultrasound surveillance of a cirrhotic liver should be investigated further with diagnostic imaging. Contrast-enhanced CT and dynamic MRI are the primary diagnostic studies for the diagnosis of HCC; contrast-enhanced ultrasound can be used as an alternative test. If a nodule has the typical hallmark of hypervascularity in the hepatic arterial phase with washout in the portal venous or delayed phase, a definitive diagnosis of HCC can be made. Nodules found during ultrasound surveillance that are smaller than 1 cm can be followed with ultrasound examinations at intervals of 3-6 months.
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.|2 Present address: Department of Radiology, Chung-Ang University Hospital, 84 Heukseok-Ro, Dongjak-gu, Seoul 156-756, Korea.
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
authors.affiliation: 1 Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.affiliation: 3 Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
authors.forename: Tae Kyoung
authors.initials: TK
authors.lastname: Kim
authors.affiliation: 4 Department of Radiology, Hospital Beaujon, Clichy, France.|5 Section of Radiological Sciences, University of Palermo, Palermo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Dioguardi Burgio
authors.affiliation: 4 Department of Radiology, Hospital Beaujon, Clichy, France.|6 INSERM UMR 773, Université Paris Diderot-Sorbonne, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D003952:Diagnostic Imaging; D018450:Disease Progression; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D003287:Contrast Media
keywords: dysplastic nodule; hepatocarcinogenesis; hepatocellular carcinoma; imaging diagnosis; liver neoplasms