SCT Diagnosis of Spontaneous Rupture of Hepatocarcinoma / 实用放射学杂志

ABSTRACT

Objective To assess the value of CT in the detection of spontaneous rupture of hepatocarcinoma as well as to assess CT finging of hepatocarcinoma rupture.Methods Clinical manifestation and CT findings of spontaneous rupture of hepatocarcinoma in 22 cases proved surgically and pathologically were reviewed. CT characters of variable pathological changes of ruptured hepatocarcinoma and its relationship to the rupture of hepatocarcinoma were also analyzed. The analysis involved the status of liver cirrhosis, ascites, intrahepatic locations of the tumor, extent of extrahepatic protrusion and central necrosis of the tumor.Results All ruptured tumours were located at the periphery of the liver, 12 cases had a protruding contour. The maximum diameter of tumours ranged from 2 to 16 cm. Discontinuity of the hepatic surface was seen in 16 cases,necrosis of core was seen in 12 cases. 3 cases with non-ruptured masses also showed contrast medium flow over the perihepatic border during the arterial phase. 2 cases showed a haematoma with attenuated rim inside the mass, but rupture was found during surgery. 1 case show detached broken bits drifting in mass ascites. In 5 cases, CT images during the arterial phase showed a non-enhancing low attenuating lesion with focal discontinuity and peripheral rim enhancement. Conclusion The accuracy of CT diagnosis of spontaneous rupture of hepatocarcinoma is very high. Moreover, CT is a necessary imaging modality in diagnosis of ruptured hepatocarcinoma suspected by clinical findings.