Characterization of hepatocellular carcinomas with triphasic CT and correlation with histopathologic findings

To determine the utility of triphasic CT in the characterization of hepatocellular carcinomas (HCCs) and correlations with histopathologic findings.

Thirty patients with hepatocellular carcinomas were included in the study and triphasic CT examinations were performed. The CT protocol included hepatic arterial, portal venous and late phases. A histopathologic examination was carried out in all but 3 patients, and the diagnosis and degrees of differentiation were determined.

Hepatocellular carcinomas were hyperattenuated in 17 (57%) and hypoattenuated in 13 (43%) of the 30 patients in arterial phase images. The lesions were hypoattenuated in 26 (87%) and hyperattenuated in 4 (13%) patients in portal venous phase images. These hyperattenuated tumors were well-differentiated in the histopathologic examinations (P < or = 0.05). Portal vein invasion was seen in 50% of the patients and this relationship was significant in patients whose lesions was greater than 10 cm (P < 0.05). Capsule formation, abnormal internal vessels and necrosis were detected in 57%, 53% and 40% of the patients, respectively.

Triphasic CT can aid in the histopathologic differentiation of HCCs, in addition to their characterization. Hyperattenuation in PVP images was found to be associated with well-differentiated HCCs and portal vein invasion was more frequent in tumors larger than 10 cm.