Abstract
BackgroundThe objective of this study was to retrospectively investigate and compare multidetector computed tomography findings of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive and -negative patients.MethodsTriphasic (arterial, portal venous, and delayed phases) dynamic multidetector computed tomography (CT) was performed in 83 patients with HCC, 48 of whom were HBV-positive. The diagnosis of HCC was established with typical CT imaging findings (68 patients) or histopathological evaluation (15 patients). Distribution of solitary, multiple, and diffuse HCC, portal/hepatic vein thrombosis, metastasis, and patients with high alpha-fetoprotein levels in the HBV-positive and -negative groups were compared using the Kolmogorov–Smirnov test. Lesion size, alpha-fetoprotein levels, arterial, portal, delayed enhancement, and washout of lesions were compared using the Student’s t-test.ResultsHypervascular tumors were observed in 72 (87%) patients, and hypovascular tumors were found in 11 (13%) patients. The mean alpha-fetoprotein value of HBV-positive patients with HCC was significantly higher than the mean alpha-fetoprotein value of HBV-negative patients (P < 0.05). Portal/hepatic vein thrombosis and metastasis were more frequently observed in HBV-positive patients (P < 0.05). The frequencies of solitary, multiple, and diffuse lesions in HBV-positive and -negative patients were not significantly different (P > 0.05). The mean diameters, arterial, portal, and delayed phase attenuations, and washout of HCC were not significantly different (P > 0.05).ConclusionsMultidetector CT imaging findings of HCC in HBV-positive and -negative patients are alike. Portal/hepatic vein thrombosis and metastasis are more frequently observed in HBV-positive patients. Alpha-fetoprotein levels are higher in HBV-positive patients.
Highlights
The objective of this study was to retrospectively investigate and compare multidetector computed tomography findings of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive and -negative patients
Triphasic dynamic computed tomography (CT) or magnetic resonance imaging (MRI) with arterial, portal venous, and delayed phase imaging is considered to be the primary approach for the diagnosis of HCC
The mean alpha-fetoprotein value of HBV-positive patients with HCC was significantly higher than the mean alpha-fetoprotein value of HBVnegative patients (P < 0.05)
Summary
The objective of this study was to retrospectively investigate and compare multidetector computed tomography findings of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-positive and -negative patients. Hepatocellular carcinoma (HCC), which is the most common primary liver tumor, accounts for 85–90% of primary liver cancers [1]. Portal venous phase imaging is useful for detecting hypovascular liver tumors, such as metastatic tumors from the colorectum, because the liver parenchyma is enhanced maximally during this phase [10]. For the detection of HCCs, portal venous phase imaging is not sensitive because the tumors often show attenuation similar to that of the enhanced liver parenchyma, resulting in decreased tumor conspicuity during this phase [7,9]. Some hypovascular HCCs may be detected only on portal venous phase images or may be depicted more conspicuously during this phase than the arterial phase. Capsule enhancement on delayed phase improves the rates of detection of HCC [12]
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