Hepatic lesion characterization in cirrhosis: significance of arterial hypervascularity on dual-phase helical CT.
OBJECTIVE
Our goal was to evaluate the diagnostic significance of the presence and pattern of arterial hypervascularity in lesions detected on dual-phase helical CT in cirrhotic patients.


METHODS
Fifty-eight lesions greater than 1 cm in size were prospectively identified in 26 patients with end-stage liver disease who had undergone dual-phase helical CT for preoperative liver transplantation evaluation. All 26 patients had diagnoses proven by histologic evaluation or by clinical criteria. All arterial phase scans were retrospectively reviewed and lesions were categorized for the presence and pattern of arterial hypervascularity. Radiologic findings were correlated with histopathologic data.


RESULTS
Thirty-seven of the 58 lesions had hypervascular components on arterial phase scans. All 37 of these lesions were found to represent hepatocellular carcinoma (HCC) (positive predictive value, 100%). Of the 21 remaining hypovascular lesions, 17 were HCC and four were benign (positive predictive value, 81%). Of the nine patients in whom all lesions were hypovascular, six had HCC (positive predictive value, 66%). The value of the presence of arterial hypervascularity for diagnosing HCC was statistically significant (p < .05). However, the presence or absence of arterial hypervascularity and the specific enhancement pattern revealed by helical CT did not correlate with histologic grading.


CONCLUSIONS
The presence of hypervascularity in hepatic masses found in cirrhotic patients is highly predictive of malignancy.
Lee
H M
HM
Department of Radiological Sciences, UCLA Medical Center 90095, USA.
Lu
D S
DS
Krasny
R M
RM
Busuttil
R
R
Kadell
B
B
Lucas
J
J
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000150:complications / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000098:blood supply / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol