Most liver cancers are accompanied by liver cirrhosis, and the problem of distinguishing liver cirrhosis nodules from liver cancer nodules is often encountered in clinic. If it is a large liver cancer, alpha-fetoprotein is positive, and it also has typical characteristics on ultrasound, CT or nuclear magnetic resonance, so it is not particularly difficult to identify it. However, some small hepatocellular carcinomas are similar to cirrhosis nodules in imaging and need to be carefully differentiated.

Of course, we should check the alpha-fetoprotein first. Alpha-fetoprotein does not increase in liver cirrhosis nodules, but in most liver cancer nodules. Imaging examination is very valuable in differentiating sclerosing nodules from hepatocellular carcinoma nodules, which is generally difficult to distinguish by ordinary ultrasound. You can use the following three methods:

1. Contrast enhanced ultrasound examination

Hepatic cancer nodules have early arterial enhancement after injection of ultrasound contrast agent, and the venous phase becomes lower than the surrounding liver parenchyma, while liver cirrhosis nodules do not have early enhancement after injection of contrast agent, but strengthen and weaken synchronously with the surrounding liver parenchyma.

2. Enhanced CT

Contrast-enhanced CT findings are similar to contrast-enhanced ultrasound, with early enhancement of hepatocellular carcinoma nodules and no early enhancement of sclerosing nodules.

3. Nuclear Magnetic Resonance * * *

Magnetic resonance imaging is more valuable in differentiating liver cirrhosis nodules from liver cancer nodules. First of all, the signals are obviously different. For example, liver cancer nodules show low signal on t 1WI(MRI terminology, the same below) weighted images, but slightly high signal on T2WI weighted images. On the other hand, sclerotic nodules showed high signal on T 1WI weighted images and slightly low signal on T2WI weighted images. In addition, magnetic resonance imaging can also be used for enhanced scanning, and sclerosing nodules can also be distinguished from liver cancer nodules by enhanced scanning.

Of course, if imaging differentiation is difficult, fine needle liver biopsy can be done if necessary, and small liver cancer or sclerosing nodules can be diagnosed through pathological examination.