Murakami T, Kim T, Takamura M, Hori M, Takahashi S, Federle M P, Tsuda K, Osuga K, Kawata S, Nakamura H, Kudo M
Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka, 565-0871, Japan.
Radiology. 2001 Mar;218(3):763-7. doi: 10.1148/radiology.218.3.r01mr39763.
To assess whether double arterial phase imaging with multi-detector row helical computed tomography improves detection of hypervascular hepatocellular carcinoma (HCC).
Fifty-one patients with 96 hypervascular HCCs underwent double arterial phase imaging of the entire liver. At measured delay after intravenous administration of 2 mL/kg of contrast medium at a rate of 5 mL/sec, the early and late arterial phase images were obtained serially during a single breath hold with interscan delay of 5.0 seconds. Detector row configuration of 2.5 x 4 mm, pitch of 6, and scanning time of 10.5 seconds for each phase were used. Forty 5-mm-thick reconstruction images were obtained for each phase. Each image set was interpreted separately by three observers, who were unaware of tumor burden in the liver, to detect hypervascular HCC. Sensitivity, positive predictive value, and area below the receiver operating characteristic curve (A(z)) for early and late arterial phases separately and together were calculated.
Mean sensitivity and positive predictive value for hypervascular HCC were 54% and 85% for the early arterial phase, 78% and 83% for the late arterial phase, and 86% and 92% for the double arterial phase, respectively. Double arterial phase imaging showed significantly superior sensitivity compared with early or late arterial phase imaging alone for detecting HCC (P <.05). The mean A(z) value for double arterial phase was significantly higher than that for early or late arterial phase imaging alone (P <.05). Double arterial phase imaging showed the lowest number of false-positive lesions.
Double arterial phase imaging is recommended to improve detection of hypervascular HCCs and reduce false-positive lesions.
评估多排螺旋计算机断层扫描的双动脉期成像是否能提高对富血供肝细胞癌（HCC）的检测能力。
51例患有96个富血供HCC的患者接受了全肝双动脉期成像。以5 mL/秒的速率静脉注射2 mL/kg造影剂后，在测量的延迟时间，于一次屏气期间连续获取早期和晚期动脉期图像，层间延迟时间为5.0秒。采用探测器排阵配置为2.5×4 mm、螺距为6且每个期相扫描时间为10.5秒。每个期相获取40幅5毫米厚的重建图像。由三名不知肝脏肿瘤负荷情况的观察者分别解读每组图像，以检测富血供HCC。分别计算早期和晚期动脉期以及两者联合时的敏感性、阳性预测值和受试者操作特征曲线下面积（A(z)）。
富血供HCC的平均敏感性和阳性预测值在早期动脉期分别为54%和85%，晚期动脉期分别为78%和83%，双动脉期分别为86%和92%。与单独的早期或晚期动脉期成像相比，双动脉期成像在检测HCC方面显示出显著更高的敏感性（P <.05）。双动脉期的平均A(z)值显著高于单独的早期或晚期动脉期成像（P <.05）。双动脉期成像显示的假阳性病变数量最少。
推荐采用双动脉期成像以提高对富血供HCC的检测能力并减少假阳性病变。
