Murakami Takamichi, Takamura Manabu, Kim Tonsok, Hori Masatoshi, Federle Michael P, Onishi Hiromitsu, Tomoda Kaname, Nakamura Hironobu
Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Eur J Radiol. 2005 May;54(2):246-52. doi: 10.1016/j.ejrad.2004.05.013.
The purpose of this study is to assess the diagnostic impact of double phase computed tomography during hepatic arteriography for hepatocellular carcinoma.
118 hepatocellular carcinomas in 73 cirrhotic patients who underwent double phase computed tomography during hepatic arteriography were enrolled in this study. Double phase computed tomography during hepatic arteriography consisted of computed tomography images obtained at 5-10 s (first phase) and 40-50 s (second phase) after the initiation of an intraarterial administration of 40-60 ml of contrast medium through the hepatic artery. Diagnostic accuracy of the first phase computed tomography during hepatic arteriography alone and double phase computed tomography during hepatic arteriography images for hepatocellular carcinoma were separately analyzed by three blinded readers independently. Alternative-free response receiver operating characteristic curves were constructed to compare each set of computed tomography during hepatic arteriography images.
The detection sensitivity of the double phase CTHA for HCC (mean, 83.1%) was significantly higher than that of the first phase CTHA alone (mean, 73.4%) (P < 0.01). Moreover, the positive predictive value of the double phase CTHA (mean, 93.7%) was higher than that of the first phase CTHA alone (87.4%). The area under the AFROC curve (Az value) of the double phase CTHA (mean, 0.88) was significantly higher than that of the first phase CTHA alone (mean, 0.77) (P < 0.05).
Double phase computed tomography during hepatic arteriography can improve the diagnostic accuracy of hepatocellular carcinoma.
本研究旨在评估肝动脉造影期间双期计算机断层扫描对肝细胞癌的诊断影响。
本研究纳入了73例肝硬化患者中的118个肝细胞癌，这些患者在肝动脉造影期间接受了双期计算机断层扫描。肝动脉造影期间的双期计算机断层扫描包括在通过肝动脉动脉内注射40 - 60 ml造影剂后5 - 10秒（第一期）和40 - 50秒（第二期）获得的计算机断层扫描图像。由三位不知情的阅片者分别独立分析肝动脉造影期间单独的第一期计算机断层扫描和肝动脉造影图像的双期计算机断层扫描对肝细胞癌的诊断准确性。构建无替代反应接受者操作特征曲线以比较每组肝动脉造影期间的计算机断层扫描图像。
肝动脉造影双期CTHA对HCC的检测敏感性（平均83.1%）显著高于单独的第一期CTHA（平均73.4%）（P < 0.01）。此外，肝动脉造影双期CTHA的阳性预测值（平均93.7%）高于单独的第一期CTHA（87.4%）。肝动脉造影双期CTHA的AFROC曲线下面积（Az值）（平均0.88）显著高于单独的第一期CTHA（平均0.77）（P < 0.05）。
肝动脉造影期间的双期计算机断层扫描可提高肝细胞癌的诊断准确性。
