Department of Radiology, Wakayama Medical University, Wakayama, Japan.
Jpn J Radiol. 2010 Feb;28(2):149-56. doi: 10.1007/s11604-009-0399-z. Epub 2010 Feb 26.
The purpose of this study was to assess the usefulness of triple-phase computed tomography during arterial portography (CTAP) using a bolus-tracking technique.
The subjects were 60 patients with hepatic tumors: 20 patients with metastatic liver tumors with a normal liver and 40 with hypervascular hepatocellular carcinoma (HCC) with liver cirrhosis. The region of interest was set in the portal vein, and CTAP was automatically started after the triggering threshold (180 HU) was reached. Three scans were performed: early phase (E), hepatic parenchymal phase (HP), and late phase (L). The scan start time of E-CTAP was measured. The detection rates of the HCC nodules were evaluated during each CTAP phase.
CTAP was performed by bolus tracking without failure in any of the patients. The mean scan start times in the normal liver group and liver cirrhosis group were 14.3 +/- 1.34 s and 18.5 +/- 2.46 s, respectively, which were significantly different from each other. The detection rates of HCC nodules for E-CTAP, HP-CTAP, and L-CTAP were 29.6%, 100%, and 83.3%, respectively.
The bolus-tracking technique enabled us to perform CTAP with optimal timing regardless of the portal blood flow dynamics.
本研究旨在评估使用团注追踪技术的动脉门静脉造影（CTAP）中三重相位 CT 的有用性。
研究对象为 60 例肝脏肿瘤患者：20 例转移性肝肿瘤伴正常肝脏患者和 40 例伴有肝硬化的富血管性肝细胞癌（HCC）患者。感兴趣区域设定在门静脉，触发阈值（180HU）达到后自动启动 CTAP。进行 3 次扫描：早期相（E）、肝实质相（HP）和晚期相（L）。测量 E-CTAP 的扫描开始时间。评估每个 CTAP 相的 HCC 结节的检出率。
在所有患者中，均成功进行了团注追踪的 CTAP，无一例失败。在正常肝组和肝硬化组中，扫描开始时间的平均值分别为 14.3 +/- 1.34 秒和 18.5 +/- 2.46 秒，两组之间存在显著差异。E-CTAP、HP-CTAP 和 L-CTAP 的 HCC 结节检出率分别为 29.6%、100%和 83.3%。
团注追踪技术使我们能够在不考虑门静脉血流动力学的情况下，以最佳时机进行 CTAP。
