Value of perfusion parameters and histogram analysis of triphasic computed tomography in pre-operative prediction of histological grade of hepatocellular carcinoma  

作　　者：Shao Chun-Chun Zhao Fang Yu Yi-Fan Zhu Lin-Lin Pang Guo-Dong 

机构地区：[1]Department of Evidence-Based Medicine,The Second Hospital,Cheeloo College of Medicine,Shandong University,Jinan,Shandong 250033,China [2]Department of Radiology,Qilu Hospital,Cheeloo College of Medicine,Shandong University,Jinan,Shandong 250012,China [3]Healthcare Big Data Institute of Shandong University,Jinan,Shandong 250000,China [4]Department of Epidemiology and Health Statistics,School of Public Health,Shandong University,Jinan,Shandong 250000,China [5]Department of Radiology,The Second Hospital,Cheeloo College of Medicine,Shandong University,Jinan,Shandong 250033,China

出　　处：《Chinese Medical Journal》2021年第10期1181-1190,共10页中华医学杂志（英文版）

摘　　要：Background:Pre-operative non-invasive histological evaluation of hepatocellular carcinoma(HCC)remains a challenge.Tumor perfusion is significantly associated with the development and aggressiveness of HCC.The purpose of the study was to evaluate the clinical value of quantitative liver perfusion parameters and corresponding histogram parameters derived from traditional triphasic enhanced computed tomography(CT)scans in predicting histological grade of HCC.Methods:Totally,52 patients with HCC were enrolled in this retrospective study and underwent triple-phase enhanced CT imaging.The blood perfusion parameters were derived from triple-phase CT scans.The relationship of liver perfusion parameters and corresponding histogram parameters with the histological grade of HCC was analyzed.Receiver operating characteristic(ROC)curve analysis was used to determine the optimal ability of the parameters to predict the tumor histological grade.Results:The variance of arterial enhancement fraction(AEF)was significantly higher in HCCs without poorly differentiated components(NP-HCCs)than in HCCs with poorly differentiated components(P-HCCs).The difference in hepatic blood flow(HF)between total tumor and total liver flow(ΔHF=HFtumor-HFliver)and relative flow(rHF=ΔHF/HF_(liver))were significantly higher in NP-HCCs than in P-HCCs.The difference in portal vein blood supply perfusion(PVP)between tumor and liver tissue(ΔPVP)and theΔPVP/liver PVP ratio(rPVP)were significantly higher in patients with NP-HCCs than in patients with P-HCCs.The area under ROC(AUC)ofΔPVP and rPVP were both 0.697 with a high sensitivity of 84.2%and specificity of only 56.2%.TheΔHF and rHF had a higher specificity of 87.5%with an AUC of 0.681 and 0.673,respectively.The combination of rHF and rPVP showed the highest AUC of 0.732 with a sensitivity of 57.9%and specificity of 93.8%.The combined parameter ofΔHF and rPVP,rHF and rPVP had the highest positive predictive value of 0.903,and that of rPVP andΔPVP had the highest negative predictive value of 0.78

关 键 词：Hepatocellular carcinoma PERFUSION Computed tomography Histological grade HISTOGRAM 

分 类 号：R735.7[医药卫生—肿瘤]