Maetani Yoji S, Ueda Mikiko, Haga Hironori, Isoda Hiroyoshi, Takada Yasutsugu, Arizono Shigeki, Hirokawa Yuusuke, Shimada Kootaro, Shibata Toshiya, Kaori Togashi
Department of Radiology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Intervirology. 2008;51 Suppl 1:46-51. doi: 10.1159/000122597. Epub 2008 Jun 10.
To compare 8-detector row helical computed tomography (CT) findings with histopathology in patients with hepatocellular carcinoma (HCC) who had undergone living-donor liver transplantation (LDLT).
This institutional review board-approved prospective study was performed between February 12, 2003 and November 12, 2004; of the 78 candidates for LDLT due to HCC who underwent preoperative multidetector CT (MDCT), 48 transplant recipients met our criteria and in 41 of them, HCCs were diagnosed with <15 lesions on MDCT; these patients represented the study population. Results of preoperative CT were correlated with histopathological results after 5-mm sagittal slicing of the explanted liver. Following the injection of contrast medium (2 ml/kg body weight of 300 mg I/ml), triple-phase contrast-enhanced images were obtained. CT was performed using the following parameters: detector row configuration, 8 x 1 mm, reconstruction interval, 1 mm, 200 mA s and 120 kVp. Image analysis was performed in consensus by three abdominal radiologists using 1-mm-thick slices with 0.5-mm overlap with paging as well as multiplanar reformatting (MPR; i.e. axial, coronal and sagittal images).
A total of 134 HCCs were identified by pathological examination. The mean lesion size was 21 mm. Sensitivity, positive predictive value and accuracy for HCC detection were 87, 96 and 84% for all lesions, respectively, and 99, 100 and 97% for lesions >1 cm, respectively, but only 46, 76 and 41% for tumors <1 cm, respectively (n = 28). There were 12 false-negative lesions but only 5 false-positive findings.
MDCT combined with the paging method and MPR images is very effective in the detection of HCCs >1 cm in diameter with a very low false-positive rate.
比较接受活体肝移植（LDLT）的肝细胞癌（HCC）患者的8排螺旋计算机断层扫描（CT）结果与组织病理学结果。
本前瞻性研究经机构审查委员会批准，于2003年2月12日至2004年11月12日进行；在78例因HCC接受术前多排CT（MDCT）检查的LDLT候选者中，48例移植受者符合我们的标准，其中41例受者的HCC在MDCT上被诊断为病灶数<15个；这些患者构成研究人群。将术前CT结果与切除肝脏经5毫米矢状切片后的组织病理学结果进行对比。注射造影剂（300毫克碘/毫升，2毫升/千克体重）后，获得三期对比增强图像。CT扫描采用以下参数：探测器排配置为8×1毫米，重建间隔为1毫米，管电流200毫安秒，管电压120千伏。由三名腹部放射科医生共同对图像进行分析，使用1毫米厚的切片，层间距0.5毫米，并进行多平面重建（MPR，即轴向、冠状和矢状图像）。
病理检查共发现134个HCC病灶。病灶平均大小为21毫米。所有病灶检测HCC的敏感性、阳性预测值和准确性分别为87%、96%和84%，直径>1厘米的病灶分别为99%、100%和97%，但直径<1厘米的肿瘤分别仅为46%、76%和41%（n = 28）。有12个假阴性病灶，但假阳性发现仅5个。
MDCT结合层间距法和MPR图像在检测直径>1厘米的HCC方面非常有效，假阳性率极低。
