Abstract: Objective To study on the relationship between Computed Tomography perfusion imaging (CTPI) parameters and Child-Pugh classification in patients with hepatocellular carcinoma (HCC). Methods Seventy-six patients with HCC from March 2018 to March 2020 were included as the research objects. All patients underwent CTPI, parameters including hepatic arterial perfusion (HAP), portal venous perfusion (PVP), mean transit time (MTT), hepatic arterial perfusion index (HAPI) were recorded. The relationship between these CTPI parameters and Child-pugh grades of the patients was analyzed. Results In these 76 patients, there were 38 cases with Child-pugh grade A, 24 cases with grade B, and 14 cases with grade C. Significant differences were found in the levels of HAP, PVP, MTT and HAPI in patients with different Child-pugh grades (P<0.05). The HAP and HAPI of grade C patients were significantly higher than those of Grade A and B, while the PVP and MTT were significantly lower than those of Grade A (P<0.05). The Pearson correlation analysis showed that the CTPI parameters such as the HAP and HAPI were positively correlated with child Pugh classification (P<0.05), whereas MTT and PVP were negatively correlated with child Pugh grades (P<0.05). The receiver operator characteristic curve (ROC) analysis showed that the HAP (AUC=0.727, 95%CI=0.562-0.892, P=0.013), PVP (AUC=0.703, 95%CI=0.574-0.832, P=0.026), MTT (AUC=0.747, 95%CI=0.601-0.894, P=0.007), HAPI (AUC=0.694, 95%CI=0.506-0.882, P=0.034) had certain value in judging Child-pugh grade C. The AUC of joint probability to predict Child-pugh C was 0.815 (95%CI=0.689-0.942, P=0.001). Conclusion The CTPI parameters are closely related to Child-pugh classification in HCC patients. CTPI parameters are helpful to predict the Child-pugh classification and provide a basis for clinical intervention.

Key words: CT perfusion imaging, hepatocellular carcinoma, Child-pugh classification