evaluation of hepatocellular carcinoma with biphasic contrast enhanced helical CT scan

To evaluate the role of biphasic contrast-enhanced helical CT including Hepatic Arterial Phase [HAP] imaging with Portal Venous Phase [PVP] imaging, in the detection and characterization of hepatocellular carcinomas. The study included 40 patients [M=26, F=14] with histopathologically proven HCC. Age range was between 30-85 years [mean=55] by following consecutive patients with cirrhosis in whom Hepatocellular carcinoma was diagnosed or suspected either by raised serum a [alpha]-fetoprotein level or Ultrasound. Biphasic contrast-enhanced examination revealed a total of 85 lesions in these 40 patients, out of which 13 were unifocal, 12 showed a dominant mass with satellite lesions, 2 showed cluster of contiguous nodules and 13 were multifocal HCCs. Mean diameter was 3.1 cm, ranging from 0.8 to 14 cm. On HAP imaging 85% were detected. [hyperattenuating = 69, hypoattenuating = 3] while on PVP imaging detectibility was only 48% [hyperattenuating=2, hypoattenuating=39]. Hence detectibility was significantly [p=0.008] superior in HAP as compared to PVP imaging. In 7 patients [17%] tumor was visible only on HAP images. Venous invasion was present in 12 patients [30%] while arterio-portal shunting was seen in 5 patients [13%]. Biphasic contrast enhanced helical CT is a useful method in detection and characterization of HCC