Kuszyk B S, Bluemke D A, Choti M A, Horton K M, Magee C A, Fishman E K
The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
AJR Am J Roentgenol. 2000 Feb;174(2):471-5. doi: 10.2214/ajr.174.2.1740471.
The purpose of this study was to evaluate the effect of lesion enhancement on the conspicuity of small hypovascular hepatic tumors in an animal model.
Seven VX2 hepatic tumors in five rabbits were imaged. Dynamic contrast-enhanced CT was performed at a single level centered over the lesions at 5-sec intervals for 119 sec after injection of 2 ml/kg i.v. contrast material at 2 ml/sec. Attenuation was measured over time within regions of interest in the tumor and normal liver, aorta, inferior vena cava, and portal vein. Lesion conspicuity, defined as the difference between the attenuation of the uninvolved liver and neoplasm, was calculated.
The mean diameter of the tumors on CT was 10 mm (range, 6-15 mm). The tumors appeared as low-attenuation lesions with progressive enhancement during the arterial phase and early portal phase. Peak mean lesion attenuation was 60 +/- 27 H (enhancement, 23 H) at 64 sec. Peak mean lesion conspicuity was 80 +/- 18 H at 39 sec, occurring 10 sec before the peak mean hepatic attenuation of 135 +/- 15 H (enhancement, 67 H) at 49 sec. Relative lesion conspicuity paralleled relative enhancement of the liver throughout the imaging period.
Although low-level tumor enhancement during the arterial phase and early portal phase reduced the conspicuity of small hypovascular tumors in this animal model, our results support the use of maximum liver enhancement as a marker for peak lesion conspicuity.
本研究旨在评估病变强化对动物模型中小的乏血供肝肿瘤可视化的影响。
对5只兔子体内的7个VX2肝肿瘤进行成像。静脉注射2ml/kg造影剂,注射速度为2ml/秒,之后在以病变为中心的单一层面进行动态对比增强CT扫描,每隔5秒扫描一次,共扫描119秒。在肿瘤、正常肝脏、主动脉、下腔静脉和门静脉的感兴趣区域内测量随时间变化的衰减值。计算病变可视化程度,其定义为未受累肝脏与肿瘤的衰减值之差。
CT上肿瘤的平均直径为10mm(范围6 - 15mm)。肿瘤表现为低密度病变,在动脉期和门静脉早期呈渐进性强化。在64秒时,病变平均峰值衰减为60±27H(强化值为23H)。在39秒时,病变平均峰值可视化程度为80±18H,比在49秒时肝脏平均峰值衰减135±15H(强化值为67H)提前10秒出现。在整个成像期间,病变相对可视化程度与肝脏相对强化程度平行。
尽管在本动物模型中,动脉期和门静脉早期肿瘤的低水平强化降低了小的乏血供肿瘤的可视化程度,但我们的结果支持将肝脏最大强化作为病变峰值可视化程度的一个指标。