Abstract: Objective The aim of this study was to compare the diagnostic efficacy of CT and magnetic resonance imaging (MRI) in the differential diagnosis of patients with hepatic hemangioma (HH) and hepatocellular carcinoma (HCC). Methods 69 patients with intrahepatic space-occupying lesions were encountered in Huai 'an First People's Hospital between June 2020 and June 2022, all patients received enhanced CT and MRI scanning, and underwent liver biopsies or hepatectomy. The Kappa test was used to analyze the agreement between CT and MRI diagnosis based on histopathological diagnosis. The area under the receiver operating characteristic curve (AUC) was applied to determine the diagnostic efficacy. Results Based on histopathological examination, the CT scan found primary liver cancer (PLC) in 29 cases (78.4%) and HH in 24 cases(75.0%), while the MRI diagnose correctly PLC in 35 cases (94.6%) and HH in 29 cases; the enhanced CT and MRI scan were consistent with the pathological diagnosis as respect to the diagnosis of HH and HCC by Kappa test (Kappa=0.532, P<0.05 and Kappa=0.749, P<0.05); the sensitivity (Se), the specificity (Sp) and the accuracy by MRI scan in diagnosing the intrahepatic occupying lesions were 94.6%, 90.6% and 92.8%, much superior to 78.4%, 75.0% and 76.8% by CT scan, while the combination of the two didn’t improve the diagnostic efficacy (90.6%, 90.6% and 92.8%, respectively). Conclusion The optimal check-up might be the MRI scan in determining the quality of intrahepatic occupying lesions.

Key words: Hepatocellular carcinoma, Hepatic hemangioma, Enhanced CT scan, Magnetic resonance imaging, Diagnosis