Preliminary application of 64-slice spiral CT whole-liver perfusion in hepatocellular carcinoma

Objective To identify the characterization of hepatocellular carcinoma (HCC) perfusion and its images under the pattern of whole-liver perfusion with 64-slice spiral CT. Methods Thirty-two patients with HCC diagnosed by clinical data or pathological detections were employed. Ten normal persons acted as control group. Non-ion contrast medium (370 mgI/ml) and normal saline was injected through antecubital vein into the cases at 5 ml/s with double tubes high-pressure syringe. The colored pictures of time density curve (TDC), hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and total liver perfusion (TLP) were harvested with special software of hepatic perfusion in CT. The parameters of perfusion were measured respectively. The condition of blood current dynamics in livers suffering HCC as well as those normal ones were evaluated based on the parameters. Results ①TDC of normal hepatic parenchyma raised slowly in arterial phase, whereas it raised fast and achieved the peaking in portal vein phase. The curve ran smoothly and softly. Contrastly, TDC of HCC performed as tachy-ascensus model. It ran fast in arterial phase and achieved the peaking near spleen peaking. The peaking of the curve presented earlier. Then the curve stayed unchanged for a time or descended quickly. ②The values of HAP and hepatic perfusion index (HPI) of HCC were (46.6±16.6) ml/(min·100 mg) and (84.0±13.1)% respectively. They were bigger than those of the normal contrast by far, and the difference was significant (HAP: t=4.32, P0.01; HPI: t=11.3, P0.01). Moreover, the values of HAP and HPI of HCC also exceeded those of distant part of hepatic parenchyma, and the difference is significant, too (HAP: t=2.08, P0.05; HPI: t=4.8, P0.01). ③The HPP of the circumferential part of the tumor with blurring edge is bigger than that of the tumor with sharp edge, the difference was significant (t=9.52, P0.01). Conclusion The whole-liver perfusion pattern with 64-slice spiral CT has some advantages, such as simplicity and practice. And the disadvantages of previous patterns of liver perfusion imaging are eliminated in this pattern. The characterization of blood current perfusion of the whole liver as well as the HCC can be identified. Thus, it can provide instructions to the diagnosis, differentiation and treatment of HCC.