Hepatocellular Carcinoma with Arterioportal Fistulas: MSCT Diagnlsis

Objective To evaluate the dynamic enhanced multi-slice CT(MSCT) features of HCC with arterioportal fistulas(APFs) and compare with arteriographic imaging fingdings. Methods 38 cases of HCC with APFs underwent dynamic enhanced MSCT scan and DSA. Using the results of DSA as the standard to analyse the diagnostic accuracy and the imagine signs of MSCT. Results All the patients had positive CT findings which related to APFs in arterial phase.The dynamic enhanced MSCT signs of APFs were divided into two types:the central type and the peripheral type. Central type of 29 cases: ①The main portal vein ( PV ) and/or the first class branches of PV were in advance revealed in the arterial phase, the density approaching the aorta. ②The embolus and its network artery of PV were revealed. While in the 9 cases of peripheral type : ①In the arterial phase,patchy high attenuation was appeared in the tumorous rim liver parenchyma; while in the PV phase, this attenuation's density became the same as that of the normal liver; ②The PV branches which inside the tumor in advance enhanced in shape of lines in the arterial phase. Conclusion As a noninvasive method,dynamic enhanced MSCT should be preterrde for the diagnosis of hepatic APFs. MSCT diagnosis of APFs is of great clinical significance in the transcatheter arterial chemoembolization(TACE).