[The dynamic computed tomography of small hepatocarcinomas treated by US-guided percutaneous ethanol injections. The short- and long-term follow-up aspects].

Dynamic CT studies with an automatic injector of iodinated contrast medium were performed in 22 patients affected with 29 hepatocellular carcinomas (HCCs) (phi: 0.8-4.5 cm) before and after treatment with percutaneous ethanol injection (PEI) and during the follow-up period, every 6-9 months. Before PEI, most of the HCCs showed contrast enhancement on CT scans. Treatment was suspended when US-guided fine-needle biopsy demonstrated the absence of malignant cells and when the lesions were unenhanced on dynamic CT scans. Dynamic CT detected 21 HCCs (72.4%) before PEI and 24 HCCs (82.8%) after PEI and during the follow-up period. After PEI, 14 HCCs exhibited a thin and hyperdense peripheral rim on dynamic CT scans. Nine of these lesions, with long-term follow-up (12-31 months), have a smaller diameter than the primary lesion; 6 patients have no HCC recurrence. The authors conclude that dynamic CT is useful for evaluating the effectiveness of PEI in the treatment of HCCs; moreover, their personal experience suggests that the finding of a thin and hyperdense peripheral rim cannot always be related to viable cancerous tissue.