Triphasic helical CT of hepatocellular carcinoma

Abstract EN

Introduction : Hepatocellular carcinoma (HCC) is the most frequent primary malignancy of the liver.

Helical CT is highly suitable for imaging of HCC.

Aim of the work: To identify tumor localization, extent & vascular pattern at different phases of contrast enhanced helical CT.

Patients & Methods : Our study included 25 patients.

The age range was between 40 up to 65 years (average 52.5 y.).

The sex distribution was 17 male (17 / 25 = 68 %) & 8 female cases (8/25=32%), they were examined firstly with abdominal US followed by triphasic helical abdominal CT.

CT guided biopsy was done for all cases.

Results : The lobar hepatic distribution of HCC was 18 cases within the RT.

Lobe (18 / 25 = 72 %), 4 cases within the LT.

lobe (4 / 25 = 16 %) and 3 cases involving both lobes (3 / 25 = 12 %).

Solitary lesions were seen in 19 cases (19 / 25 = 76 %) & multifocal type in 6 cases (6 / 25 = 24 %).

HCC was laree (more than 3 cm) in 13 cases (13 / 25 = 52 %) & small in .size (less than 3 cm) in 12 cases (12 / 25 = 48 %).

The pre-contrast CT density pattern of HCC were of mixed density in 10 cases, hypoden.se in 13 cases, hyperdense in one case & isodense in one case.

Post-contrast CT density pattern in the *arterial phase were 10 cases mixed density.

4 cases marginal enhancement, 3 cases hyperdense.

2 cases mosaic & 2 cases nodular pattern.** Venous phase were 16 cases hypodense, 5 cases isodense & 4 cases mixed density.

21 cases (84%) were hyper-vascular & 4 cases (16 %) were hypovascular.

Tumor rupture was noted in two eases.

Conclusion: Triphasic study of the liver is helpful in tumor localization, extension & size.

In addition, it is useful in differentiation of vascular from non vascular tumors as well as identification of the dillerent vascular patterns.

Tumor rupture was easily diagnosed by helical CT.