Differential value of multislice CT angiography in hepatic focal nodular hyperplasia, hepatocellular carcinoma and liver hemangioma

Abstract

Objective To evaluate the differential diagnostic value of MSCT angiography in hepatic focal nodular hyperplasia(FNH), hepatocellular carcinoma(HCC) and hepatic hemangiomas(HA). Methods The clinical data of patients with liver tumor who underwent MSCT angiography in Peking University Shenzhen Hospital from March 2008 to March 2014 were analyzed retrospectively, including 19 patients with FNH, 19 patients with HCC and 17 patients with HA. MSCT angiography was used in three-dimensional reconstruction of tumor vessels. The image characteristics of tumors, such as tumor feeding arteries, arteriovenous fistula, portal vein tumor emboli, draining vein, feeding arteries into the center of the low density, low density separator film, and pseudocapsule, were observed and analyzed statistically by chi-square test. Results Feeding artery thickening was found in all of the patients with FNH, HCC and HA. The display rate were 95.2%(20/21), 100.0%(21/21), and 77.3%(17/22), respectively. There were no statistical differences among the three groups (all P values>0.05). Except for feeding artery thickening, pseudocapsule, portal vein tumor emboli and arteriovenous fistula were found in patients with FNH and HCC but not in patients with HA, especially pseudocapsule which was higher than those in patients with FNH (66.7%, 14/21) and HCC(71.4%, 15/21). So the emergence of pseudocapsule could exclude HA, which could differentiate HA from FNH and HCC. Draining vein, feeding arteries into the center of the low density and low density separator film in patients with FNH were 61.9%(13/21), 38.1%(8/21), and 61.9%(13/21), respectively, which were significantly higher than those in patients with HCC[9.5%(2/21), 0(0/21), 0(0/21)], there were statistically differences(χ2=12.548, 7.560, 18.828, all P values<0.05). Portal vein tumor emboli and arteriovenous fistula were not found in patients with FNH but found in patients with HCC[(19.0%, 4/21), (28.6%, 6/21)] , especially the emergence of portal vein tumor emboli supported HCC diagnosis, which could differentiate HCC from FNH. Conclusions MSCT angiography has great values in the differential diagnosis and important clinical significance for FNH, HCC and HA. It can help guide surgeons to choose the best way of treatment. Key words: Liver diseases; Tomography, spiral computed; Angiography; Focal nodular hyperplasia; Carcinoma, hepatocellular