| Summary: | Hepatocellular carcinoma (HCC) can be diagnosed noninvasively on multiphasic CT and MRI
based on its distinctive imaging findings. These features include arterial phase hyperenhancement
and washout on portal or delayed phase images. However, radiologists face significant diagnostic
challenges because some HCCs exhibit atypical imaging characteristics. In addition to
many HCC-mimicking lesions, such as arterioportal shunts, combined HCC-cholangiocarcinoma,
intrahepatic cholangiocarcinoma, and hemangioma present a challenge for radiologists in actual
clinical practice. The ability to distinguish HCCs from mimickers on initial imaging examinations is
crucial for appropriate management and treatment decisions. Therefore, this pictorial review
presents the imaging findings of atypical HCCs and HCCs mimicking malignant and benign lesions
and discusses important clues that may help narrow down the differential diagnosis.
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