Triphasic helical CT of hepatocellular carcinoma

ABSTRACT

Hepatocellular carcinoma [HCC] is the most frequent primary malignancy of the Iiver. Helical CT is highly suitable for imaging of HCC. To identify tumor localization, extent and vascular pattern at different phases of contrast enhanced helical CT. Our study included 25 patients. The age range was between 40 up to 65 years [average 52.5 y.]. The sex distribution was 17 male [17/25=68%] and 8 female cases [8/25=32%], they were examined firstly with abdominal US followed by triphasic helical abdominal CT. CT guided biopsy was done for all cases. The lobar hepatic distribution of HCC was 18 cases within the RT. Rt. Lobe [18/25=72%], 4 cases within the lt. lobe [4/25=16%], and 3 cases involving both lobes [3/25=12%]. Solitary lesions were seen in 19 cases [19/25=76%] and multifocal type in 6 cases [6/25=24%]. HCC was large [more than 3 cm] in 13 cases [13/25=52%] and small in size [less than] 3 cm] in 12 cases [12/25=48%]. The pre-contrast CT density pattern of HCC were of mixed density in 10 cases, hypodense in 13 cases, hyperdense in one case and isodensc in one case. Post-contrast CT density pattern in the asterisk arterial phase were 10 cases, mixed density, 4 cases marginal enhancement, 3 cases hyperdense, 2 cases mosaic and 2 cases nodular pattern. Asterisk asterisk Venous phase were 16 cases hypodensc, 5 cases isodense and 4 cases mixed density.21 cases [84%] were hypervascular and 4 cases [16%] were hypovascular. Tumor rupture was noted in two cases. Triphasic study of the liver is helpful in tumor localization. extension and size. In addition, it is useful in differentiation of vascular from non vascular tumors as well as identification of the different vascular patterns. Tumor rupture was easily diagnosed by helical CT