Abstract: Objective This study aimed to investigate diagnostic performance of serum alpha-fetoprotein (AFP) levels and multilayer spiral CT-detected parameters in evaluating qualities of liver nodules. Methods Clinical data of 124 patients with liver nodules were collected in our hospital between October 2021 and October 2023, and all underwent CT scan for determination of mean transit time (MTT),permeability surface area product (PS), blood volume (BV) and blood flow (BF) of regions of interest. Serum AFP, carcinoembryonic antigen (CEA),carbohydrate antigen 199 (CA-199) and tumor specific growth factor (TSGF) levels were assayed by ELISA. Multivariate Logistic regression analysis and area under receiver operating characteristic curve (AUC) were applied to assess diagnostic efficacy. Results Of 124 patients with intrahepatic nodules, histo-pathological examination found benign lesions in 83 cases (66.9%) and malignant lesions in 41 cases (33.1%);PS, BV and BF in malignant lesions were (10.4±3.2)mL/(min·100 g), (4.0±1.6)mL/100 g and (26.5±5.6)mL/(min·100 g), all much higher than [(6.2±1.5)mL/(min·100 g), (1.9±0.5)mL/100 g and (17.9±3.5)mL/(min·100 g), respectively, P＜0.05] in benign ones; serum AFP, CA-199 and TSGF levels were (416.4±150.1)μg/L,(44.6±5.9)U/L and (78.3±8.3)U/mL, all much higher than [(11.8±2.3)μg/L,(36.2±4.5) U/L and (59.7±6.2)U/mL, respectively, P＜0.05] in benign lesions; multivariate Logistic regression analysis showed that PS, BV and BF as well as serum AFP levels were independent risk factors for HCC existence (P＜0.05);ROC analysis demonstrated that the AUC was 0.967(95%CI:0.927-1.000), with sensitivity of 985.1% and specificity of 95.1%, when CT parameters and serum AFP level combination in judging the quality of intrahepatic nodules. Conclusion CT parameters in combination with serum AFP levels could help in the differential diagnosis of benign and malignant intrahepatic nodules,which could guide clinical management.

Key words: Hepatoma, Liver focal nodular lesions, Alpha-fetoprotein, Multilayer spiral CT scan, Diagnosis