Feature analysis of computed tomographic signs of hepatocellular carcinoma in multiphase studies

Abstract

Hepatocellular carcinoma is one of the actual problems in the structure of oncological pathology in the world and in Kazakhstan. In the diagnosis of hepatocellular carcinoma, the use of multiphase computed tomography is generally accepted. The article describes the analysis of the results of multiphase computer tomography with the correlation of cytological and histological studies in the diagnosis of hepatocellular carcinoma. Present study aimed to conduct a retrospective analysis of the results of multiphase computer tomography in patients with hepatocellular carcinoma Analyzed the archival data of 50 patients with malignant liver tumors, who received specialized treatment at the A.N. Syzganov National scientific center of surgery and Kazakh Scientific Research Institute of Oncology and Radiology in the period 2014 - 2017. All patients underwent multiphase computed tomography. The examination was carried out in 4 phases: native, arterial, port-venous and delayed. The scan was performed on the 30th, 60th and 120 second (respectively) after the administration of contrast agent. The nodular form was detected in 76% of cases. If in 60% of cases the tumor was localized in the right lobe of the liver, and in 18% of cases - in the left, the lesion of both lobes was observed in 22% of cases. The sizes of the tumors were from 1 cm to 21.1 cm, and the average size of all nodes was 10.6 cm. The outlines of the tumors were uneven, but clearly defined in 92% of cases. In 94% of cases, the density of the formations was hypodense, the structure was heterogeneous with areas of increased and decreased density. The presence of central necrosis in the form of an “asterisk” was visualized in 8% of cases. The non-intensive inhomogeneous hyperenhancement in the arterial phase, with complete “washout” into the porto-venous phase, as well as in the porto-venous and delayed phases, was observed in 6% and 12% cases, respectively. In 80% of cases, hyperenhancement was observed in the arterial and venous phases. At the same time, complete erosion in the delayed phase was observed in 60% of cases, and incomplete leaching - 20%. In cytological studies, hepatocellular carcinoma was confirmed in 69.7% of cases. In 93.1% of cases, hepatocellular carcinoma was confirmed in histological studies. The nodes of hepatocellular carcinoma in most cases were characterized by clear, uneven contours, hypodense density, heterogeneous structure due to foci of necrosis and cystic component. When the tumor was bolus contrasted, hyperenhancement was in the arterial and port-venous phases, with “washout” in the delayed phase in most cases. According to the received data it can be said that multiphase computed tomography has high information value in the diagnosis of hepatocellular carcinoma.