ABSTRACT
Objective To study the helical CT dual-phase feature of peripheral enhancement in small hepatocellular carcinoma (SHCC) and to evaluate its correlation with the histopathology. Methods The helical CT dual-phase feature of peripheral enhancement in SHCC was analyzed in 17 cases with 18 lesions, all the lesions were confirmed by operation and histopathology. Results In 17 lesions, peripheral enhancement ring of the lesions wasn′t intact, the thickness of peripheral enhancement ring wasn′t uniform, and small nodular enhancement was found inside the peripheral enhancement ring in hepatic arterial phase (HAP). In 1 lesion, the peripheral enhancement ring of the lesion was intact and the thickness of peripheral enhancement ring was uniform in HAP. The density of the peripheral enhancement ring and the small nodular enhancement decreased to hypodense or isodense than the normal liver parenchyma in portal venous phase. Pathologic pattern: 16 lesions were trabecular type and 2 lesions were scirrhous type. The differentiation of the tumor cell was grade I in 2 lesions, grade Ⅱ in 14 lesions, grade Ⅲ in 1 lesion, and grade Ⅳ in 1 lesion, respectively. In 12 lesions, the vessels were richer in the lesion border than that in the lesion center. In 6 lesions, the vessels were less rich in both center and border. In 3 lesions, the pseudo-capsule was showed in the border of the lesion. In 10 lesions, the flecks of necrosis were demonstrated in the border and/or center of the lesion. Conclusion The helical CT dual-phase feature of peripheral enhancement in SHCC is characteristic, and SHCC might be distinguished from other hepatic diseases with peripheral enhancement.