ISSN 1305-3825 | E-ISSN 1305-3612
Abdominal Imaging - Original Article
Correlation of dynamic multidetector CT findings with pathological grades of hepatocellular carcinoma
1 Departments of Radiology, Başkent University Faculty of Medicine Ankara, Turkey  
2 Departments of Pathology, Başkent University Faculty of Medicine Ankara, Turkey  
3 Department of Radiology, Başkent University School of Medicine, Ankara, Turkey  
Diagn Interv Radiol 2011; 17: 328-333
DOI: 10.4261/1305-3825.DIR.2682-09.3
Key Words: carcinoma, hepatocellular • tomography, spiral computed • diseases, liver
Abstract

PURPOSE
Our objective was to examine whether different vascularization patterns seen during three phases of dynamic multidetector computed tomography (MDCT) of the liver correlated with the histopathological differentiation findings of hepatocellular carcinoma (HCC) in chronic liver disease patients.

 

MATERIALS AND METHODS
Dynamic MDCT images from 46 patients (38 males and 8 females; ages between 1 and 90 years; mean age, 53) pathologically diagnosed with HCC were retrospectively evaluated. Lesions were divided into three groups according to MDCT enhancement patterns. Pathologically determined differentiation degrees were compared with contrast enhancement patterns in the hepatic arterial, portal venous, and hepatic venous phases.

 

RESULTS
Lesion characterization was as follows: Type 1 (6 patients), hypoattenuating in the hepatic arterial and hepatic venous phases and hyperattenuating in the portal venous phase; Type 2 (10 patients), hypoattenuating in all phases; and Type 3 (30 patients), hyperattenuating in the hepatic arterial and portal venous phases and hypoattenuating in the hepatic venous phase. Patients were pathologically classified as having either well-differentiated (n=32) or poorly differentiated HCC (n=14). All patients with poorly differentiated HCC had a Type 3 enhancement pattern. All patients with Type 1 and 2 enhancement patterns had well-differentiated HCC. There was a significant correlation between pathological differentiation degrees and radiological enhancement (P = 0.003).

 

CONCLUSION
Dynamic MDCT revealed that poorly differentiated HCC patients all had hypervascular enhancement patterns, and hypovascular- type enhancement was present in all patients with well-differentiated HCC. Imaging patterns of dynamic MDCT scanning in HCC patients may be helpful for follow-up examinations and for determining clinical prognosis.

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