Abstract: Objective To investigate computed tomography (CT) perfusion imaging of hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia (FNH), and its role in differential diagnosis.Methods 24 HCC patients and 17 FNH patients in our hospital from March 2015 to November 2015 were enrolled. CT routine scan and liver perfusion scan were carried out in all those patients. Comparison of CT perfusion values, including hepatic arterial perfusion, portal perfusion, hepatic perfusion, hepatic arterial perfusion index, between HCC and FNH group, as well as carcinoma, peri-carcinoma and distant liver in HCC, and lesions and distant liver in FNH group, respectively.Results Comparing with FNH group, HCC group showed lower hepatic arterial perfusion and hepatic arterial perfusion index, but higher portal venous perfusion, which were statistically significant differences. Among cases with HCC, carcinoma tissue showed higher hepatic artery perfusion and hepatic arterial perfusion index than peri-carcinoma and distant liver, but lower portal perfusion, which were statistically significant differences. Similarly, focal tissue in FNH group showed higher hepatic arterial perfusion lesion, hepatic arterial perfusion index and lower portal venous perfusion than distant liver tissue with statistically significant differences. However, the total liver perfusion in all comparisons had no statistically significant differences.Conclusion CT perfusion imaging and relative value analysis might play important roles in differential diagnosis between HCC and FNH.

Key words: Hepatocellular Carcinoma, Hepatic focal nodular hyperplasia, CT perfusion imaging, Hepatic arterial perfusion, Portal venous perfusion, Differential diagnosis