Observation on imaging characteristics of multi-slice spiral CT enhanced scanning in the diagnosis of hepatic hemangioma and its differentiation from hepatic metastasis

Abstract

Abstract: Objective To explore the value of multi-slice spiral CT (MSCT) enhanced scanning in the diagnosis of hepatic hemangioma (HH) and hepatic metastasis. Methods Between March 2022 and January 2024, 82 cases of HH and 82 cases of liver metastases were collected. According to the standard reconstruction algorithm, the outline of the tumor including plain scan, arterial phase, portal phase and delayed phase was carefully drawn manually along the boundary of the tumor, and the parameters of enhanced CT scanning were automatically obtained. Results HH hepatic blood flow, hepatic blood volume, contrast agent transit time and capillary surface permeability were (152.4±23.8) mL/(100 g·min), (22.5±4.7) mL/100 g, (14.2±1.3) s, (33.6±9.2)%, compared with liver metastases [(193.5±31.6) mL/100 g/min, (14.1±3.5) mL/100 g, (9.3±1.0) s, (27.0±7.9)%], the difference was statistically significant (P<0.05). There were 116 lesions in 82 cases of HH, of which 80 were <10 cm and 36 were >10cm. It was found that the tumor volume, tumor enhancement volume and arterial phase enhancement ratio of the lesions >10 cm HH [(104.2±23.2) mm³, (41.8±9.3) mm³ and (41.3±4.6) %] had the significant difference (P<0.05) when compared with <10 cm HH [(314.5±72.3) mm³, (53.8±10.9) mm³, (27.1±2.9)%]. The fusion lesions, subcapsular distribution, target ring sign, quasi-circular center low density and bull's eye sign in HH were 43 cases (52.4%), 60 cases (73.2%), 23 cases (28.0%), 3 cases (3.6%) and 1 case (1.2%), compared with liver metastases [2 cases (2.4%), 0(0), 0(0), 51 cases (62.2%) and 37 cases (45.1%)], the difference was statistically significant (P<0.05). The results of MSCT, as the experimental group, were defined as positive and negative results by referring to pathological results. The sensitivity, specificity and accuracy of MSCT in diagnosing HH were 90.2% (74/82), 84.1% (69/82) and 87.2% (143/164), which were in good agreement with pathological results (Kappa coefficient = 0.710). Conclusion Taking pathological results as the gold standard, MSCT has a good consistency in differential diagnosis of HH, which shows that the application of enhanced CT scanning mode can know the blood supply of HH patients in time, and can accurately identify HH, which has a positive effect on guiding the formulation of reasonable treatment plans.

Key words: Hepatic hemangioma, Hepatic metastasis, Multi-slice spiral CT

LI Wei, HUANG Shi-kun, REN Dao-chang, TANG Yan. Observation on imaging characteristics of multi-slice spiral CT enhanced scanning in the diagnosis of hepatic hemangioma and its differentiation from hepatic metastasis[J]. Chinese Hepatolgy, 2024, 29(9): 1074-1076.

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