| BackgroundHepatocellular carcinoma (HCC) is the most frequent malignant primary tumor of the liver.It is the fifth most common tumor in the world and third in cancer related mortality after lung and stomach cancer. Incidence of HCC is higher in the Asia and Africa where the prevalance of hepatitis B and hepatitis C is high which predispose the development of chronic liver disease and subsequently development to the hepatocellular carcinoma. In the past HCC is generally presented at advanced stage with clinical features of right upper abdominal pain,eight loss and sign of decompensation liver disease but due to invention of different technology in medical field early diagnosis is possible. Diagnosis of HCC can be made by screening of the patients with higher risks as in chronic HBV and HCV, serological marker AFP is usually done but cannot always reliable. Image modalities for HCC are ultrasound (USG), computed tomography (CT), Magnetic resonance imaging (MRI).Treatment options of hepatocellular carcinoma are Surgical, ablative therapy, transarterial embolization, chemoembolization, radiotherapy, combination transarterial and ablative, external-beam therapy, systemic chemotherapy, hormonal immunotherapy. Prognosis is usually poor and once the patient is diagnosed with HCC, overall survival rate is up to5years is40to75%.Objectives:The main aim of this study was to evaluate the accurate diagnosis by evaluating the different enhancement patterns of hepatocellular carcinoma by three phase of multidetecter computed tomography of the liver and the influence of the size of the tumor to correlate with histopathologic findings accordingly in the patients with chronic liver disease for follow up examinations and for determining the clinical prognosis.Materials and methods:30Patients, between2010and2012from surgical ward of China Japan Union hospital, the third affiliated hospital of Jilin University were selected. Pathologically diagnosed HCC were evaluated retrospectively. All patients those who had surgery had also undergone MDCT images and a comparative analysis were made with the pathologically determined differentiation degree of HCC.Results:Out of30patients25were males and5were females, size ranged between1.1and10.5cm mean size and standard deviation was5.83±SD2.33with age range between32and79mean age and standard deviation was53.33±SD11.35were selected from surgical ward. Pathologically diagnosed HCC were evaluated retrospectively The result of MDCT shows HCC in type I have hypoattenuating in the hepatic arterial phase, hepatic portal phase and hepatic venous phase; type Ⅱ shows hyperattenuation in the hepatic arterial and hypoattenuation in hepatic portal phase and hepatic venous phase and type III hyperattenuation in the hepatic arterial and hepatic portal phase and hypoattenuation hepatic venous phase. Pathologically classified as well differentiated HCC were seen in5cases, moderately differentiated in22cases and poorly differentiated HCC in3cases. The size of tumor more than5cm had poorly differentiated HCC with presence of portal vein invasion and there was no poorly differentiated HCC in less than5cm.Conclusion; MDCT revealed that poorly differentiated HCC patients had hypervascular patterns and hypovascular enhancement patterns was present in all the well differentiated HCC and moderately differentiated HCC. Portal invasion was seen more in the large sized tumor than the smaller one. Imaging scanning in HCC patients may be helpful for follow up examinations and for the clinical prognosis... |
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