Value of magnetic resonance combined with dual-source CT in the differential diagnosis of hepatic hemangioma and hepatocellular carcinoma

Abstract

Abstract: Objective To investigate the value of magnetic resonance imaging (MRI) combined with dual-source CT three-phase enhanced scanning in the differential diagnosis of hepatic hemangioma (HHE) and hepatocellular carcinoma (HCC). Methods 42 patients with HHE (51 lesions in total) and 60 patients with HCC (65 lesions in total) admitted to the hospital from April 2020 to November 2022 were selected as subjects. All patients underwent MRI and dual-source CT three-phase enhanced scanning. The imaging data of lesions obtained from plain CT scan were compared between patients with HHE and HCC. The gold standard for analysis was pathological diagnosis, which was used to assess the consistency of MRI, dual-source CT three-phase enhanced scanning and their combination with pathological diagnosis. Receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was used to evaluate the diagnosis value of MRI, dual-source CT and their combination in distinguishing between HEE and HCC. Results MRI detection results: 46 lesions were detected in 42 HHE patients, with a detection rate of 90.20%; 60 lesions were detected in 60 HCC patients, with a detection rate of 92.31%. Results of dual-source CT three-phase enhanced scanning: 41 lesions were detected in 42 patients with HHE, with a detection rate of 80.39%; 54 lesions were detected in 60 patients with HCC, with a detection rate of 83.08%. The number of circular lesions, the degree of border indistinctness, and the number of single lesions in HCC patients were higher than those in HHE patients (P<0.05). There was no significant difference in lesion density between HHE and HCC patients (P>0.05).The total coincidence rate of MRI in distinguishing HEE from HCC compared to pathological diagnosis was 91.38%. The Kappa consistency test indicated that there was a good consistency (Kappa=0.821, P<0.05) between MRI and pathological diagnosis in identifying HHE and HCC. The total coincidence rate of three-phase dual-source CT scanning in distinguishing HEE from HCC was 81.90%. The Kappa consistency test, indicated that there was a general consistency (Kappa=0.714, P<0.05) between dual-source CT three-phase enhanced scanning and pathological diagnosis in identifying HHE and HCC. The total coincidence rate of the combined examination in distinguishing HEE from HCC was 96.55%. The Kappa consistency test indicated that there was a good consistency (Kappa=0.895, P<0.05) between the combined examination and pathological diagnosis in identifying HHE and HCC. ROC curve results showed that the AUC values of MRI, dual-source CT three-phase enhanced scanning and the combined diagnosis of HEE and HCC were 0.913, 0.817 and 0.965, respectively (P<0.05), and the AUC value of MRI was higher than that of dual-source CT three-phase enhanced scanning (P<0.05). The AUC value of combined diagnosis was higher than that of single diagnosis (P<0.05). Conclusion MRI and dual-source CT are valuable tools for distinguishing between HHE and HCC, and their combination has a higher value in the differential diagnosis.

Key words: Magnetic resonance, Dual-source CT three-stage enhanced scanning, Hepatic hemangioma, Hepatocellular carcinoma, Differential diagnostic value

HAN Xue-feng, JING Gui-yin, GE Shang. Value of magnetic resonance combined with dual-source CT in the differential diagnosis of hepatic hemangioma and hepatocellular carcinoma[J]. Chinese Hepatolgy, 2023, 28(10): 1199-1203.

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