肝细胞癌（HCC）经过多个肝癌发生阶段，每个阶段的特点是血管供应、引流和微血管结构的特定变化。这些血管变化显着影响 HCC 的影像学表现，从而实现非侵入性诊断。 HCC 的血管变化与侵袭性组织学特征和治疗反应密切相关。从肿瘤向周围肝脏门静脉的静脉引流促进血管侵袭，而包裹肿瘤簇的独特的微血管模式（称为 VETC 模式）促进血管侵袭和转移。越来越多地使用的 HCC 全身治疗主要针对密切相关的血管生成和免疫检查点途径。通过了解肝癌发生过程中组织病理学血管变化及其对影像学结果的影响之间的复杂关系，放射科医生可以提高影像诊断的准确性，并改善预后和治疗反应的预测。反过来，这最终将带来更好的患者护理。版权所有 © 2024 韩国放射学会。

Hepatocellular carcinoma (HCC) progresses through multiple stages of hepatocarcinogenesis, with each stage characterized by specific changes in vascular supply, drainage, and microvascular structure. These vascular changes significantly influence the imaging findings of HCC, enabling non-invasive diagnosis. Vascular changes in HCC are closely related to aggressive histological characteristics and treatment responses. Venous drainage from the tumor toward the portal vein in the surrounding liver facilitates vascular invasion, and the unique microvascular pattern of vessels that encapsulate the tumor cluster (known as a VETC pattern) promotes vascular invasion and metastasis. Systemic treatments for HCC, which are increasingly being used, primarily target angiogenesis and immune checkpoint pathways, which are closely intertwined. By understanding the complex relationship between histopathological vascular changes in hepatocarcinogenesis and their implications for imaging findings, radiologists can enhance the accuracy of imaging diagnosis and improve the prediction of prognosis and treatment response. This, in turn, will ultimately lead to better patient care.Copyright © 2024 The Korean Society of Radiology.