Hemodynamic study of hepatocellular carcinoma nodules by multi-slice spiral computed tomographic perfusion

Abstract

To analyze the 64-slice computed tomographic (CT) perfusion parameters of hepatocellular carcinoma (HCC) nodule so as to assess the diagnostic value of hemodynamic changes of HCC nodule by this perfusion technique. Forty volunteers without liver disease (control subjects) and 37 HCC patients (experimental group) were selected. After informed consents, all of them underwent plain, perfusion and contrast CT examinations. Perfusion CT scan was performed at 120 kV, 60 mA and a thickness of up to 40 mm. The injection rate of contrast medium was 4 - 5 ml/sec at a dose of 1.0 ml/kg body weight. And 50 seconds of continuous scanning time was set at 5 seconds post-injection. The indices were 1 second per 360° revolution, 5 mm slice thickness image reconstruction and a matrix size of 512×512 pixels. Perfusion parameters associated with changes in hepatic blood flow included blood flow (HBF), hepatic blood volume (HBV), hepatic arterial perfusion index (HAI), hepatic artery perfusion (HAP) and portal venous perfusion (HPP). Perfusion parameters were measured thrice at each time point for each different region of interest (ROI): hepatic parenchyma surrounding HCC nodule, HCC nodule and normal liver parenchyma(control group). For HCC nodule, the increased levels of HBF, HAP and HAI were significantly differentiated from normal liver parenchyma of control group (P < 0.01). Increased HBV and decreased HPP had no difference from control group (P > 0.05). Higher levels of HAP, HPP and HAI in HCC nodules were differentiated from hepatic parenchyma surrounding HCC nodules (P < 0.05). HBV decreased and HBF increased in HCC nodule. But it had no differences from hepatic parenchyma surrounding HCC nodule (P > 0.05). Perfusion CT may visualize the status of liver blood flow caused by HCC nodule so as to serve as a new tool of studying the hemodynamic changes of HCC nodules.