Feasibility analysis of dual-source CT dual-energy scanning in differentiating small hepatocellular carcinoma,regener-ating nodules of cirrhosis and evaluating microvascular invasion of small hepatocellular carcinoma

YANG Zhangzhe; LIN Xili; ZENG Fangyi; YE Fei

doi:10.20258/j.cnki.1006-9011.2025.11.017

Abstract：Objective To analyze the feasibility of dual-source CT dual-energy scanning in differentiating small hepatocellu-lar carcinoma,regenerating nodules of cirrhosis(CRN)and evaluating microvascular invasion of small hepatocellular carci-noma.Methods Clinical data of 206 patients(274 nodules)with cirrhosis and intrahepatic nodular lesions admitted to our hos-pital were retrospectively analyzed.97 cases of CRN and 177 cases of small liver cancer were confirmed by fine needle puncture or postoperative histopathology.The parameters of dual-source CT dual-energy scanning with different nodule properties(blood volume(BV),hepatic artery fraction(HAF),blood flow(BF),and hepatic artery perfusion volume(HAP))were compared,and the parameters and detection rate of hepatic artery third-stage intensification were compared in patients with small liver can-cer.The differential diagnostic value of dual-source CT dual-energy scanning was analyzed by receiver operating characteristic(ROC)curve.By comparing the results of dual-source CT dual-energy scan with microvascular invasion in small liver cancer,the relationship between dual-source CT dual-energy scan and microvascular invasion in small liver cancer was analyzed.Results The absolute value,enhancement value and detection rate of late and middle arterial CT were higher than those of early arterial CT(P<0.05).The absolute value,enhancement value and detection rate of late and middle arterial CT were higher than those of early arterial CT(P<0.05).Logistic regression was used to fit the hepatic artery stage III and the scanning param-eters,and the AUC of the combined differential diagnosis of small liver cancer was 0.929,which was higher than that of the he-patic artery Stage III,which had the largest AUC among the individual indicators(Z=2.766,P=0.034).The diameter and iodine enhancement value of the lesions with microvascular invasion were higher than those without microvascular invasion,while,BV,HAF,BF and HAP were lower than those without microvascular invasion(P<0.05).Multivariate Logistic regression analysis showed that lesion diameter,iodinogram enhancement value,BV,HAF,BF and HAP were significantly correlated with micro-vascular invasion of small hepatocellular carcinoma(P<0.05).Conclusion Dual-source CT dual-energy scanning parameters have high diagnostic value in differentiating small liver cancer and CRN,and are closely related to microvascular invasion of small liver cancer,which has high clinical application value.