This case shows typical hepatocellular carcinoma (HCC) on top of cirrhotic liver with porta-hepatis and peri-pancreatic lymphadenopathy as well as dilatation of the intra-hepatic biliary radicles and ascites.

Hyperintensity on both T2- and diffusion-weighted images is helpful in the diagnosis of hypervascular HCC. Fat-containing hypervascular liver lesions that are hypointense on in-phase with further signal drop out in the out-of-phase sequence (chemical shift artefact) are strongly associated with the diagnosis of HCC.

Delayed hypointensity and enhancing rim improve the specificity of diagnosis of small HCC.