Distinct MDCT imaging features to differential diagnosis of hepatic paragonimiasis and small hepatocellular carcinoma
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Sheng Zhang1,2,*, Si-Ming Xie3,*, Yong-Hua Chen1, Xu-Bao Liu1 and Gang Mai4
1Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
2Department of General Surgery, The First Affiliated Hospital of Xinxiang Medical College, Weihui 453100, Henan Province, China
3Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
4Department of Hepatobiliary Surgery, The People’s Hospital of Deyang, Deyang 618000, Sichuan Province, China
*These authors have contributed equally to this work and are joint first authors of this manuscript
Gang Mai, email: [email protected]
Keywords: paragonimiasis, hepatocellular, hepatic, MDCT, carcinoma
Received: November 08, 2016 Accepted: February 07, 2017 Published: March 15, 2017
We used multi-row detector computed tomography (MDCT) to identify the distinguishing characteristics of hepatic paragonimiasis and small hepatocellular carcinoma lesions. We analyzed a cohort of 60 patients, of which 26 had hepatic paragonimiasis and 34 with a small (≤ 3cm) hepatocellular carcinoma. MDCT detected 65 lesions that were retrospectively reviewed and analyzed based on their imaging features. Both groups showed distinct MDCT imaging features that could contribute to an accurate diagnosis. In the paragonimiasis group, 75% (21/28) lesions were located in the hepatic subcapsular region, whereas only 10.8% (4/37) of lesions in the hepatocellular carcinoma group were subcapsular. Most hepatic paragonimiasis lesions (57.1%; 16/28) also showed characteristic tubular or tunnel features that were not present in hepatocellular carcinomas. Further, 71.4% (20/28) paragonimiasis lesions were rim enhanced with irregular tract-like non-enhanced internal areas with a characteristic target loop, while 94.6% (35/37) of small hepatocellular carcinoma lesions showed homogenous enhancement in the arterial and venous phase. In addition, the period CT values for hepatic paragonimiasis were less than those of hepatic carcinomas (P<0.001). These clinically significant findings illustrate the diagnostic features that enable one to distinguish hepatic paragonimiasis from small hepatocellular carcinomas.
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