Laghi Andrea, Iannaccone Riccardo, Rossi Plinio, Carbone Iacopo, Ferrari Riccardo, Mangiapane Filippo, Nofroni Italo, Passariello Roberto
Department of Radiology II, University of Rome-La Sapienza, Policlinico Umberto I, Viale Regina Elena 324, 00161 Rome, Italy.
Radiology. 2003 Feb;226(2):543-9. doi: 10.1148/radiol.2262012043.
To evaluate whether the use of two arterial phase image acquisition series, when combined with portal venous phase imaging at multi-detector row helical computed tomography (CT), would be superior enough to use of a single arterial phase image acquisition series to warrant the increased radiation dose.
Multi-detector row CT was performed in 77 patients with 140 foci of hepatocellular carcinoma (HCC). A triple-phase protocol that included an early arterial phase, a late arterial phase, and a portal venous phase was performed. Images were analyzed separately by three radiologists to document the presence and number of HCC nodules. Separate reading sessions were performed for images from the early arterial phase, images from the late arterial phase, images from both arterial phases combined, and images from all three phases. Sensitivity and positive predictive values were calculated for each reading session.
The average sensitivity and positive predictive values, respectively, for the detection of HCC were 48.5% and 96.4% for early arterial phase images, 87.1% and 94.0% for late arterial phase images, 87.1% and 94.0% for images from both arterial phases, and 88.5% and 93.4% for images from all three phases. Analysis of images from both arterial phases together yielded no improvement in either sensitivity or positive predictive value compared with analysis of late arterial phase images alone. Analysis of the combination of late arterial and portal venous phase images resulted in the highest sensitivity value.
The acquisition of images during two arterial contrast phases does not provide additional benefit over timed conventional biphasic CT technique.
评估在多排螺旋计算机断层扫描（CT）中，使用两个动脉期图像采集序列并结合门静脉期成像，是否足以优于使用单个动脉期图像采集序列，从而证明增加的辐射剂量是合理的。
对77例患有140个肝细胞癌（HCC）病灶的患者进行多排螺旋CT检查。采用包括早期动脉期、晚期动脉期和门静脉期的三相扫描方案。三位放射科医生分别对图像进行分析，记录HCC结节的存在情况和数量。对早期动脉期图像、晚期动脉期图像、两个动脉期图像合并后的图像以及所有三个期相的图像分别进行阅片。计算每个阅片阶段的敏感性和阳性预测值。
对于HCC检测，早期动脉期图像的平均敏感性和阳性预测值分别为48.5%和96.4%，晚期动脉期图像为87.1%和94.0%，两个动脉期图像合并后的图像为87.1%和94.0%，所有三个期相的图像为88.5%和93.4%。与单独分析晚期动脉期图像相比，同时分析两个动脉期图像在敏感性或阳性预测值方面均未得到改善。晚期动脉期和门静脉期图像联合分析的敏感性值最高。
与定时传统双期CT技术相比，在两个动脉对比期采集图像并无额外益处。
