Study of the Capability of Multislice CT to Diagnose Arterioportal Shunt in Hepatocellular Carcinoma

OBJECTIVE This study was designed to evaluate the capability of muitislice CT (MSCT) for the diagnosis of arterioportal shunt (APS) associated with hepatocellular carcinoma (HCC).

METHODS A total of 282 patients with HCC were examined by both enhanced thin slice MSCT scanning and digital subtraction angiography (DSA) in the early hepatic-arterial phase, late hepatic-arterial phase and portal-venous phase. The criteria for diagnosis of APS were: (1) Earlier enhancement or stronger opacification of the main portal trunk and/or the first order branches compared with that of the superior mesenteric vein or splenic vein; (2) Earlier enhancement or stronger opacification of the second order and smaller portal venous branches compared with that of the main portai trunk. The presence and degree of APS demonstrated with MSCT and DSA were analyzed by a double-blind method.

RESULTS In 282 HCC patients, 56 were complicated with APS. MSCT demonstrated central APS in 48 patients of which 41 had a severe, and 7 a moderate shunt. One revealed no APS by DSA due to a giant HCC focus. Among the 7 patients with mild peripheral APS, 2 lesions were not detected by DSA due to faint shunt, and one lesion in the patient with a mixed APS was detected by both MSCT and DSA.

CONCLUSION MSCT is a simple, effective and noninvasive new technique for the diagnosis of APS associated with HCC.