关键词: 肝细胞癌, 肝脏局灶性结节性增生, CT定量参数, 肝血流量, 诊断

Abstract: Objective The aim of this study was to investigate the performance of CT quantitative parameters in the differential diagnosis of focal nodular hyperplasia (FNH) and hepatocellular carcinoma (HCC). Methods Fifty-one patients with HCC and forty-one patients with FNH were encountered in our hospital between August 2017 and August 2022, and the diagnosis was proved by histo-pathological examination. All patients underwent CT plain scan and perfusion scan, and the CT quantitative parameters, including hepatic blood volume (HBV), hepatic blood flow (HBF), hepatic artery perfusion (HAP), portal vein perfusion (PVP), total liver perfusion (TLP), hepatic artery perfusion index (HPI) and mean transit time (mTT), were recorded. The diagnostic efficacy was analyzed by ROC curve, and the diagnostic accuracy was analyzed by Kappa consistency. Results The HBV, HBF and PVP in cancerous foci were (31.9±10.1)mL/100mL,(204.7±66.3)mL/(100mL·min) and (22.8±6.4)mL/(100mL·min), all significantly higher than [(21.4±6.8)mL/100mL, (115.7±33.9)mL/(100mL·min) and (9.2±3.0)mL/(100mL·min), P＜0.05], while the HAP, HPI and mTT were (42.8±12.7)mL/(100mL·min), (64.1±10.7)% and (5.3±1.5)s, all significantly lower than [(61.8±20.4)mL/(100mL·min), (87.5±6.1)% and (8.2±2.4)s, respectively, P＜0.05] in foci of FNH; the ROC analysis showed that the AUCs were 0.787, 0.951, 0.811, 0.915, 0.949 and 0.841(all P＜0.05), when the HBV, HBF, HAP, PVP, HPI and mTT were applied to predict HCC; the Kappa consistency demonstrated that the sensitivity, specificity and accuracy were 0.941, 0.976 and 0.957 (Kappa=0.912) when the combination of HBV, HBF, HAP, PVP, HPI and mTT was applied for the diagnosis of HCC. Conclusion The differentiating diagnosis of HCC from FNH by CT quantitative parameters is efficacious, which might greatly help appropriate management in clinical practice.

Key words: Hepatoma, Focal nodular hyperplasia of liver, CT quantitative parameters, Hepatic blood flow, Diagnosis