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《Radiologic Practice》 2008-03
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CT Perfusion Imaging of Liver:the Role in the Diagnosis of Early Hepatocellular Carcinoma

WANG Shuang,ZHAO Xin-ming,LIN Meng,et al.Department of Radiology,Cancer Hospital,Chinese Academy of Medical Sciences,Beijing 100021,P.R.China  
Objective:To assess the value of CT perfusion imaging in the diagnosis of early hepatocellular carcinoma (HCC) by comparing CT perfusion images among different sizes of HCCs as well between cirrhotic liver parenchyma and small HCC (d≤3.0cm). Methods:CT perfusion imaging of liver were performed by multi-slice CT scanner in 59 patients with HCC (59 lesions), of which 30 patients were associated with liver cirrhosis.Blood flow (BF),blood volume (BV),hepatic arterial fraction (HAF),mean transit time (MTT),permeability surface area product (PS) and time of arrival of HCC lesion and cirrhotic liver parenchyma were measured,and the colored perfusion maps for each of the above-mentioned parameters were acquired.Results:There were no significant statistical difference in the above-mentioned parameters between varied size of HCCs (P0.05).Of the 59 HCCs,there were 14 tumors with the diameter ≤ 3cm,all of these tumors ≤3cm in diameter showed BF,BV and HAF higher than those of the tumor-free cirrhotic liver parenchyma (P0.05).And the areas under the receiver operating characteristic curves were 0.757,0.848 and 0.969,respectively.Otherwise,no significant difference was seen in the other perfusion parameters (P0.05).Conclusion:CT perfusion imaging,especially HAF measurement,was helpful in detecting early HCC within cirrhotic liver parenchyma.Using the value of 0.308 as the diagnostic threshold,the sensitivity and specificity of HAF reached 100% and 90% respectively.
【CateGory Index】: R735.7
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