Triple-Phase Multidetector Computed Tomography in Distinguishing Canine Hepatic Lesions

Abstract

The liver has a unique vascular supply, and triple-phase contrast-enhanced computed tomography examinations are being performed in order to characterize liver lesions. This study aimed to look for any associations between the attenuation values of liver lesions and their histological classification. The inclusion criteria for this retrospective study were focal or multifocal liver lesions and histological diagnosis. All of the dogs underwent pre-contrast and triple-phase postcontrast computed tomography (CT) examinations with identical timings of the postcontrast series. Thirty-one dogs were included in the study, and various benign and malignant pathologies were identified. The results did not identify any significant differences between the benign and malignant liver lesions, nor between the individual histological diagnoses. Inflammatory lesions were significantly different compared to the normal liver parenchyma, and significant hypoattenuation was found in the portal and delayed venous phases. Hemangiosarcomas were significantly hypoattenuating to the normal liver parenchyma in the pre-contrast and arterial phases, and also to all of the benign lesions in the arterial phase. The other pathologies showed variable attenuation patterns in the different postcontrast phases, and differentiation was not possible. On the basis of this study, triple-phase contrast-enhanced computed tomography cannot differentiate between benign and malignant liver lesions, and biopsy and further histological analysis are necessary.

Computed tomography findings in canine cholangiocellular carcinoma

“…In this study, cholangiocellular carcinoma tended to show rim enhancement in the arterial phase and progressive enhancement. In veterinary medicine, CT features of liver neoplasms, including HCC, hepatocellular adenoma, hyperplasia, hemangiosarcoma, lymphoma and carcinoid, are reported 6,8,9,24,25 . Briefly, HCC show heterogeneous enhancement with hyper‐, iso‐ or hypoattenuation compared to normal liver parenchyma in the arterial phase, and hypoattenuation in the portal and equilibrium phases 6,8 .…”

“…Hyperplasia show homogeneous enhancement with hyper‐ or isoattenuation in the portal venous and equilibrium phases 6,8 . Hemangiosarcoma shows hypoattenuation lesion in the precontrast and the arterial phases, and partially enhanced with a non‐enhanced hypoattenuation area in portal and equilibrium phases 9 . Hepatic lymphoma shows hypoattenuation lesion compared to normal liver parenchyma in pre‐ and postcontrast triple phases 24 .…”

“…In veterinary medicine, CT features of liver neoplasms, including HCC, hepatocellular adenoma, hyperplasia, hemangiosarcoma, lymphoma and carcinoid, are reported. 6,8,9,24,25 Briefly, HCC show heterogeneous enhancement with hyper-, iso-or hypoattenua-tion compared to normal liver parenchyma in the arterial phase, and hypoattenuation in the portal and equilibrium phases. 6,8 Hepatocellular adenoma shows diffuse enhancement in the arterial and portal phases.…”

“…In veterinary medicine, triple-phase computed tomography (CT) is used to differentiate liver neoplasms, including hepatocellular carcinoma (HCC), nodular hyperplasia, hemangiosarcoma and metastatic tumours. [6][7][8][9] However, there is limited information on the CT features of cholangiocellular carcinoma in dogs. In humans, CT is the standard imaging modality to assess cholangiocellular carcinoma.…”

Hypoattenuating periportal halo on CT in a patient population can occur in presence of a variety of diseases

“…The selection of the patients was based on the CT routine protocol examination established at our institutions in the last 5 years. The lack of image acquisition during the arterial and portal phase [27] could have let some hepatic lesions unrecognized and possible presence of PPH only in the portal phase undetected.…”