Study progression MRI findings with pathologic correlation in hepatitis B virus-associated multistage hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. It is recognized that the vast majority of HCC (90%) develops in a hepatitis/cirrhotic setting, of which the early detection is very important. Pathologically, HCC develops in a multistage fashion in the following steps: from regenerative nodules (RNs), low-grade dysplastic nodules (LGDNs), high-grade dysplastic nodules (HGDNs, the premalignant phase, borderline lesions), nodule-in-nodule HCC, early small HCCs (eHCC, the early carcinoma phase, well-differentiated), progressed small HCCs (pHCC, well to moderately-differentiated), and large HCCs (moderately to poorly-differentiated, so-called classical HCC). Characterization of cirrhotic nodules on the basis of imaging and pathologic findings is complicated by an overlap in findings associated with each type of nodule, a reflection of their multistep transitions. Recent progress in imaging modality, especially MRI, is starting to play a crucial role in the evaluation of hepatocarcinogenesis, which facilitates detection and characterization in most cases of cirrhotic nodules. In this review paper, we go over and detailedly illustrate the pathological features and MR imaging findings of these nodular lesions, and enable to understand these nodules more completely, so as to accurately diagnose cirrhotic nodules.