Abstract: Objective This study aimed to analyze clinical clues of microvessel density (MVD) exhibited by MSCT perfusion imaging parameters in patients with hepatocellular carcinoma (HCC). Methods A total of 128 patients with HCC were encountered in Fourth Medical Center, PLA General Hospital, between October 2023 and October 2025, and all underwent MSCT perfusion imaging to measure perfusion imaging parameters, such as blood flow (BF), mean transit time (MTT), permeability surface (PS) and hepatic artery perfusion (HAP) at focal lesions pre-operationally. Tissue MVD formation was detected by immunohistochemistry. Multivariate Logistic regression analysis was applied to find impacting factors for MVD formation. Results Of the 128 patients with HCC, MVD was found positive in 102 cases (79.7%); size of tumors, percentage of low differentiation, BF, PS and HAP in patients with positive MVD were (7.8±1.2)cm, 60.8%, (108.5±20.8)mL/(100 mL·min^-1), (25.5±4.8)mL/(100mL·min^-1) and (50.5±7.3)mL/(100 mL·min^-1), all significantly greater than [(5.5±1.0)cm, 30.8%, (84.5±10.1)mL/(100 mL·min^-1), (20.7±3.4)mL/(100mL·min^-1) and (42.2±8.2)mL/(100 mL·min^-1), respectively, P＜0.05], while MTT was (15.9±7.1)s, significantly less than [(19.4±6.1)s, P＜0.05] in those with MVD negative; multivariate Logistic regression analysis showed that tumor size, low differentiation, BF≥99.8 mL/(100 mL·min^-1), MTT≤17.4 s, PS≥22.3 mL/(100 mL·min^-1) and HAP≥43.3 mL/(100 mL·min^-1) were all the independent risk factors for MVD formation (P＜0.05)in patients with HCC. Conclusion MSCT perfusion imaging parameters could hint MVD existence in patients with HCC, which might help clinicians make appropriate management strategy, and improve prognosis of patients with HCC.

Key words: Hepatoma, Microvessel density, Multi-slice spiral computed tomography perfusion imaging, Impacting factors