Angiogenesis of hepatocellular carcinoma under multislice spiral CT plain scan and enhanced scan

Abstract

This study explores the value of 64-layer spinal computed tomography (CT) in diagnosing hepatocellular carcinoma (HCC) through performing dynamic contrast-enhanced scans. The study includes analysis of enhancement presentation of HCC in dynamic contrast-enhanced scan performed by multislice spinal CT (MSCT), comparison of detection rate and positive predictive value of neoplastic foci in subdivided arterial phases and portal venous phases, optimization of optimal scanning scheme for diagnosing HCC and discussion of the value of quantitative indexes such as T-D curve, maximum enhancement rate and clearance rate in diagnosing and identifying HCC. A total of 61 lesions were detected in 40 patients with HCC who were selected from the First Peoples Hospital, Jining, Shandong, China. Density difference was observed with statistical significance between the solid part of tumor and normal liver in different periods after CT scan and enhanced scan (H = 45.208, P less than 0.01), and difference in the late arterial phase was the most obvious; enhanced peak value mostly appeared in the late arterial phase. In terms of lesion detection rate, the difference of HCC detection rate was statistically significant in early, middle and late arterial phase and early and late portal vein phases (χ² = 32.910, P = 0.001) and the rate was the highest in the late arterial phase (78.689%). Lesions were divided into 3 cm or less group (small HCC) and over 3 cm group based on the maximum parameter. Detection rate of the late arterial phase was the highest, 85% (3 cm or less) and 75.61% (over 3 cm), respectively. When lesions with high density in arterial phase and/or low density in portal venous phase were considered as positive, and moreover, those confirmed clinically or pathologically were as true positive, we found positive predictive value of the over 3 cm group reached 100% in all phases, but that of 3 cm or less group was the highest (100%) in early and late portal venous phases. Among four scanning schemes involving early, middle and late arterial phases, detection rate of the early and late arterial phases and three arterial phases were consistent, reaching the highest value (3 cm or less group: 90%; the 3 cm over group: 78.049%). This study confirmed that the late arterial phase was the best time to detect abundant blood supplied HCC. The scanning scheme involving double arterial phases (early and late), late portal venous phase and stable phase which can help improve detection rate and correct diagnosis rate of HCC, was thought to be the most effective. Using dynamic enhanced CT examination in the diagnosis of HCC is meaningful both in qualitative and quantitative diagnosis. T-D curve, in particular, can intuitively and objectively reflect enhanced characteristics of HCC, and can be used to make a preliminary diagnosis of some atypical liver cancers