MRI Sequences and Clinical Features | I-HCA | H-HCA | -HCA |
T1 weighted imaging | Isointense to mildly hypertense | Isointense to hyperintense | Isointense to hyperintense [22] [23] |
T2 weighted imaging | Markedly T2 hyperintense Atoll sign: incomplete T2 hyperintense rim | Isointense to mildly hyperintense | Poorly demarcated T2-hyperintense scar [23] |
Post-contrast imaging | Arterial enhancement that persists on later phases | Variable arterial enhancement that does not persist on later phases | May mimic HCC with arterial enhancement with washout [22] Poorly demarcated scar that enhances in the portal venous phase [23] |
Prevalence rate | 40% - 50% of cases | 30% - 40% of cases | 15% - 20% of cases |
Risk for malignant transformation | 11% [23] | No to low risk [23] [24] | Up to 46% [24] |
Hemorrhage | 16% - 30% [23] [25] | 9% [23] [25] | 14% [25] |
Management considerations | Conservative management if <5 cm and stable | Conservative management if <5 cm and stable | Resection regardless of size |