Abstract: Objective To explore the clinical value of CT perfusion imaging combined with color Doppler sonography in the diagnosis of hepatic nodular lesions. Methods 50 patients with liver nodular lesions were admitted to our hospital between January 2016 and December 2018, and underwent CT and sonography. The hepatic artery perfusion (HAP),portal vein perfusion (HPP), total hepatic perfusion (TLP) and hepatic arterial perfusion index (HAPI) were measured, and the contrast enhancement time, peak time, and initial regression time of different lesions were recorded. Results The HAP of hepatic hemangioma was (0.7±0.2) mL·min^-1·mL^-1, much greater than (0.4±0.2)mL·min^-1·mL^-1 of hepatocellular carcinoma and (0.3±0.2)mL·min^-1·mL^-1 of hepatic metastases (P<0.05), the HPP was (0.6±0.2)mL·min^-1·mL^-1 , much greater than (0.2±0.1) mL·min^-1·mL^-1 of carcinoma and (0.4±0.1) mL·min^-1·mL^-1 of hepatic metastasis (P<0.05), the TLP was (1.4±0.4) mL·min^-1·mL^-1, greater than (0.7±0.3) mL·min^-1·mL^-1 of carcinoma and (0.8±0.4) mL·min^-1·mL^-1 of hepatic metastases, while the HAPI of hepatocellular carcinoma is (0.7±0.2) mL·min^-1·mL^-1, significantly higher than (0.4±0.1) mL·min^-1·mL^-1 of hepatic metastases and (0.5±0.2) mL·min^-1·mL^-1 of hepatic hemangioma (P<0.05); the hepatocellular carcinoma showed ring-shaped hyperechoic enhancement, and hypoechoic in delayed phase, and the contrast mode was “fast-forward and fast-out”, liver metastasis showed were uniformly enhanced, diffusely enhanced in the portal phase, and mostly hypoechoic in the delayed phase, and the hepatic hemangioma was mostly enhanced in the circumferential ring, isechoic in the delayed phase, and the contrast mode was “slow-in and slow-return”; the onset of enhancement in hepatocellular carcinoma was (13.2±4.0) s, much faster than (15.6±2.4) s and (18.7±3.2) s in liver metastases and hepatic hemangioma (P<0.05), the peak time was (19.2±3.4) s, much faster than (28.3±5.9) s and (67.3±24.2) s, while the fading time in hepatic hemangioma was (307.4±75.6)s, significantly slower than (39.1±4.2) s and (35.4±6.8)s in hepatocellular carcinoma and hepatic metastases (P<0.05). Conclusion The application of CT perfusion imaging combined with color Doppler sonography might help distinguish hepatic malignancy from benign ones.

Key words: Liver nodular lesions, Hepatocellular carcinoma, CT perfusion imaging, Contrast-enhanced ultrasound, Diagnosis