Diffuse perfusion abnormality of the liver parenchyma on angiography-assisted helical CT in relation to cirrhosis and previous treatments - A potential diagnostic pitfall for detecting hepatocellular carcinoma

We evaluated diffuse perfusion abnormality of the Liver parenchyma in relat ion to cirrhosis and previous treatments and estimated its potential limita tion in detecting hepatocellular carcinomas (HCCs) on CT arterial portograp hy (CTAP) and CT hepatic arteriography (CTHA). Sixty-one patients of liver cirrhosis with or without HCC received both CTAP and CTHA. Irregular defect s of enhancement of the liver parenchyma on CTAP were noted in 37 of 61 pat ients (60.7%) and compensatory arterial perfusion in these defects an CTHA was noted in 30 of 37 patients (81.1%). Most patients had segmental or mixe d patterns of enhancement. In patients with severe cirrhosis. irregular enh ancement was often noted. The irregularity was also more often in patients who had had previous treatments, Four of 40 HCC nodules in 18 patients with severe irregular perfusion were not detected on CTAP and CTHA. Diffuse per fusion abnormalities of the liver parenchyma on CTAP and CTHA would decreas e the accuracy of tumor detection in HCC patients. (C) 2001 Elsevier Scienc e Int. All rights reserved.