Application Of Ctperfusion Imaging To Diagnosing Hepatocellular Carcinoma

Objective To evaluate the value of CT perfusion imaging (CTPI) in diagnosing hepatocellular carcinoma (HCC)Methods CTPI was carried out in 21 patients with 26 lesions to obtain the following perfusion parameters:hepatic blood flow (HBF), hepatic blood volume (HBV), mean transit time (MTT), permeability surface area product (PS) and hepatic arterial fraction (HAF). All the parameters from lesion and non-lesion areas were compared with each other. In addition, serum AFP was measured in HCC patients and a liner correction analysis between AFP level and the CTPI parameters was performed.Result CTPI was failure in 3 cases with 3 lesions and success in 18 patients with 23 lesions, including 18 in HCC,4 in hemangioma of the liver and 1 in hepatic focal nodular hyperplasia (FNH). Comparing HCC parameters in 18 lesions and non-lesions, it was found that the significant differences of parameters between the two areas were HAF, which was 4.11 times higher than that in non-lesion, and MTT and PS, which were lower than latter significantly. HBF and HBV were no significant difference comparing with non-lesion. On the other hand, the correlation between serum AFP level and CTPI parameters of HCC lesion was insignificant. The differences of all parameters between lesion and non-lesion in hemangioma were similar to those in HCC, except for a higher HBF in lesion than in HCC. There is no significant difference between the parameters of FNH and non-nodule.Conclusions CTPI will play an important role in diagnosis and differential diagnosis of patients with HCC, especially when AFP is negative and/or the imaging manifestation is atypical in contrast CT.