1. MR
1.1. T1
1.1.1. variable
1.2. T2
1.2.1. slightly hyperintense
1.3. arterial enhancement
1.4. capsule will enhance on delayed
1.5. spin echo
1.5.1. lack of flow void
2. USS
2.1. small lesions
2.1.1. hyperechoic but can be
2.1.1.1. iso/hypoechoic
2.2. larger lesions
2.2.1. heterogenous
2.2.1.1. hyperechoic areas
2.2.1.1.1. fat
2.2.1.1.2. acute haemorrhage
2.2.1.2. anechoic areas
2.2.1.2.1. necrosis
2.2.1.2.2. old haemorrhage
2.3. thin hypoechoic capsule may be seen
2.4. infiltrative
2.4.1. distortion of normal liver parenchyma
3. Demographics
3.1. 10-14yo
3.2. M >F (slightly)
3.3. Seen in South East Asia
3.3.1. slow decline with Hep B vaccine uptake
3.4. Other Assoc
3.4.1. biliary atresia
3.4.2. Wilsons
3.4.3. glycogen storage disease
4. AFP raised
5. Tx and Prognosis
5.1. not sensitive to chemo
5.2. poor prognosis
5.2.1. advanced disease at presentation
6. CT
6.1. unenhanced
6.1.1. solitary mass
6.1.1.1. hypoattenuating
6.1.2. multipls smaller masses
6.1.2.1. again, hypoattenuating
6.1.3. mosaic appearance
6.1.3.1. fat
6.1.3.2. necrosis
6.1.3.3. calc
6.1.3.4. haemorrhage
6.2. enhancement
6.2.1. arterial
6.2.1.1. as its supplied by the hepatic artery
6.2.2. delayed
6.2.2.1. may/may not washout
6.2.2.2. capsule will enhance in delayed
6.2.3. vascular invasion may be seen