Associated computed tomographic features and quantitative measurement of ruptured hepatocellular carcinoma

Abstract

Abstract

Ruptured hepatocellular carcinoma (HCC) is a life-threatening complication. The Computed Tomographic (CT) features of ruptured HCC confirmed the diagnosis of a peripherally located tumor with a contour bulge. The associated CT features and quantitative measurement are poorly understood. The assessment of the associated features of ruptured HCC may improve an accurate diagnosis, prognostic understanding, and treatment procedures. The associated CT features and quantitative measurement of ruptured HCC were retrospectively evaluated to improve accurate diagnosis and prognostic evaluation. The case group of 53 patients with ruptured HCC and the control group of 94 randomly selected HCC patients without ruptured tumors was clinically reviewed. The maximal tumor dimension, area, volume, protrusion length and height were greater in the rupture group, with the protrusion ratio and CT attenuation significantly lower. Tumor protrusion, extrahepatic invasion, metastasis, abnormal vascularity, ascites, necrosis and tumor thrombus were also significantly higher in the rupture group. Among the parameters, the protrusion height showed the highest association. Multivariable analysis determined that maximal tumor dimension and tumor protrusion were independently associated with ruptured HCC. Tumor protrusion showed the best correlation. Maximal tumor dimension at a cut-off value of 6.3 cm gave optimal sensitivity (88.7%) and specificity (73.4%). Maximal tumor dimension and tumor protrusion were independently associated with ruptured HCC. The maximal tumor dimension exceeded 6.3 cm and tumor protrusion height of more than 3 cm were suggestive of imminent HCC rupture.