关键词: 原发性肝癌, 双源CT肝动脉三期扫描, 增强灌注扫描, 肝硬化, 诊断

Abstract: Objective The aim of this study was to investigate the diagnostic performance of dual-source CT hepatic artery three-phase scanning and enhanced perfusion scanning in finding small primary liver cancer (sPLC) under the background of liver cirrhosis. Methods 130 patients with liver cirrhosis and intrahepaticnodules were encountered in our hospital between February 2019 and September 2021, and all underwent dual-source CT hepatic artery three-phase scanning and enhanced perfusion scanning.The blood volume (BV), hepatic artery fraction (HAF), blood flow (BF) and hepatic arterial perfusion (HAP) were recorded. The histopathological diagnosis was made by post-operational or needle aspiration biopsy specimen. The receiver operating characteristic curve (ROC) was drawn, and the area under the curve (AUC) was applied to analyze the diagnostic performance of dual-source CT hepatic artery three-phase scan and enhanced perfusion scan for sPLC under liver cirrhosis background. Results 85 patients with sPLC was proven by pathological examination out of the 130 patients with liver cirrhosis in our series, with the average diameter of(1.85±0.37)cm at range of 0.8-3.0 cm; the absolute CT value of malignant lesion at late arterial and mid-arterial stage were(69.8±15.9)Hu and (65.8±15.2)Hu, both significantly higher than [(48.4±10.3)Hu, P＜0.05], the enhancement CT value were (24.9±5.1)Hu and (23.6±4.9)Hu, both significantly higher than [(15.2±3.9)Hu,P＜0.05], and the detection rates were 91.3% and 88.0%, both significantly higher than 40.2% (P<0.05) at early arterial stage;the BV, HAF, BF and HAP in sPLC lesions were (17.4±5.1)mL/100 g, (0.21±0.02), (183.8±15.4)mL/(min·100 g) and (38.4±4.9)mL/(min·100 g), all significantly lower than [(19.4±6.9)mL/100 g, (0.26±0.03), (201.9±18.3)mL/(min·100 g) and (52.3±5.6)mL/(min·100 g), respectively, P＜0.05] in benign lesions in 45 patients; the AUCs were (95%CI):0.842(0.768-0.899) and 0.888(0.821-0.936) by dual-source CT hepatic artery three-phase scanning and enhanced perfusion scanning in diagnosingsPLC under the background of liver cirrhosis, with the sensitivities of 83.5% and 90.6% and the specificities of 84.8% and 87.0%(Z=1.012, P=0.312). Conclusions Both the application of dual-source CT hepatic artery three-phase scanning and the enhanced perfusion scan is helpful for the detection of small primary liver cancer under the background of liver.

Key words: Primary liver cancer, Dual-source CT hepatic artery three-phase scan, Enhanced perfusion scan, Liver cirrhosis, Diagnosis