Spectrum of Pitfalls, Pseudolesions, and Potential Misdiagnoses in Cirrhosis.
AJR Am J Roentgenol. 2018 Jul;211(1):87-96. doi: 10.2214/AJR.18.19781. Elsayes KM1, Chernyak V2, Morshid AI1, Tang A3, Kielar AZ4,5, Bashir MR6, Sirlin CB7.
OBJECTIVE: The purposes of this article are to review a variety of pitfalls in liver imaging that can lead to the inaccurate diagnosis of focal hepatic lesions in cirrhosis, to describe the pathophysiologic processes of these pitfalls, and to provide specific clues for achieving the correct diagnoses.
CONCLUSION: Cirrhosis complicates liver imaging. The distortion and replacement of normal liver parenchyma by fibrous and regenerative tissue can change the typical appearance of many benign lesions, causing them to be misinterpreted as malignancy. In addition, the high incidence and prevalence of hepatocellular carcinoma among patients with cirrhosis put radiologists on high alert for any suspicious findings, especially because not all hepatocellular carcinomas have a typical imaging appearance.