Characterization of hepatocellular carcinomas with triphasic CT and correlation with histopathologic findings

Purpose: To determine the utility of triphasic CT in the characterization of hepatocellular carcinomas (HCCs) and correlations with histopathologic findings. Material and Methods: Thirty patients with hepatocellular carcinomas were included in the study and triphasic CT examinations were performed. The CT protocol included hepatic arterial, portal venous and late phases. A histopathologic examination was carried out in all but 3 patients, and the diagnosis and degrees of differentiation were determined. Results: Hepatocellular carcinomas were hyperattenuated in 17 (57%) and hypoattenuated in 13 (43%) of the 30 patients in arterial phase images. The lesions were hypoattenuated in 26 (87%) and hyperattenuated in 4 (13%) patients in portal venous phase images. These hyperattenuated tumors were well-differentiated in the histopathologic examinations (P less than or equal to 0.05). Portal vein invasion was seen in 50% of the patients and this relationship was significant in patients whose lesions was greater than 10 cm (P < 0.05). Capsule formation, abnormal internal vessels and necrosis were detected in 57%, 53% and 40% of the patients, respectively. Conclusion: Triphasic CT can aid in the histopathologic differentiation of HCCs, in addition to their characterization. Hyperattenuation in PVP images was found to be associated with well-differentiated HCCs and portal vein invasion was more frequent in tumors larger than 10 cm.