title: Correlation of dynamic multidetector CT findings with pathological grades of hepatocellular carcinoma.
abstract: OBJECTIVE
  Our objective was to examine whether different vascularization patterns seen during three phases of dynamic multidetector computed tomography (MDCT) of the liver correlated with the histopathological differentiation findings of hepatocellular carcinoma (HCC) in chronic liver disease patients.
  
  
  METHODS
  Dynamic MDCT images from 46 patients (38 males and 8 females; ages between 1 and 90 years; mean age, 53) pathologically diagnosed with HCC were retrospectively evaluated. Lesions were divided into three groups according to MDCT enhancement patterns. Pathologically determined differentiation degrees were compared with contrast enhancement patterns in the hepatic arterial, portal venous, and hepatic venous phases.
  
  
  RESULTS
  Lesion characterization was as follows: Type 1 (6 patients), hypoattenuating in the hepatic arterial and hepatic venous phases and hyperattenuating in the portal venous phase; Type 2 (10 patients), hypoattenuating in all phases; and Type 3 (30 patients), hyperattenuating in the hepatic arterial and portal venous phases and hypoattenuating in the hepatic venous phase. Patients were pathologically classified as having either well-differentiated (n=32) or poorly differentiated HCC (n=14). All patients with poorly differentiated HCC had a Type 3 enhancement pattern. All patients with Type 1 and 2 enhancement patterns had well-differentiated HCC. There was a significant correlation between pathological differentiation degrees and radiological enhancement (P = 0.003).
  
  
  CONCLUSIONS
  Dynamic MDCT revealed that poorly differentiated HCC patients all had hypervascular enhancement patterns, and hypovascular- type enhancement was present in all patients with well-differentiated HCC. Imaging patterns of dynamic MDCT scanning in HCC patients may be helpful for follow-up examinations and for determining clinical prognosis.
authors.affiliation: Department of Radiology, Başkent University Faculty of Medicine Ankara, Turkey. caglat@gmail.com
authors.forename: Nefise Cağla
authors.initials: NC
authors.lastname: Tarhan
authors.forename: Tuğçe
authors.initials: T
authors.lastname: Hatipoğlu
authors.forename: Eylül
authors.initials: E
authors.lastname: Ercan
authors.forename: Merve
authors.initials: M
authors.lastname: Bener
authors.forename: Göksun
authors.initials: G
authors.lastname: Keleş
authors.forename: Ceyla
authors.initials: C
authors.lastname: Başaran
authors.forename: Banu
authors.initials: B
authors.lastname: Bilezikçi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D060787:Neoplasm Grading; D055815:Young Adult