Department of Diagnostic Radiology, Fukuiken Saiseikai Hospital, Fukui, 918-8503, Japan.
Cardiovasc Intervent Radiol. 2011 Feb;34(1):81-6. doi: 10.1007/s00270-010-9835-9. Epub 2010 Mar 24.
The purpose of this study was to evaluate the detectability of corona enhancement around the hypervascular hepatocellular carcinoma (HCC) by dual-phase cone-beam computed tomography during hepatic arteriography (CBCTHA). Dual-phase CBCTHA was performed for 71 HCC lesions (mean ± SD 1.7 ± 0.9 cm), including seven presenting a nodule-in-nodule appearance and nine hypervascular pseudolesions. The first scan was performed during injection of 30-40 ml half-diluted contrast material at a rate of 1.5-2 ml/s through the hepatic artery. Scanning was initiated 7 s after the beginning of contrast material injection. The second scan was started 30 s after the end of the first scan. Detectability of corona enhancement on second-phase CBCTHA was evaluated. Thickness of corona enhancement was also analyzed as thin (≤2 mm) or thick (>2 mm). Corona enhancement was detected in 63 (88.7%) of 71 tumors (1.8 ± 0.9 cm), but it was not detected in eight tumors (1.0 ± 0.2 cm). Thin corona enhancement was seen in 18 tumors (1.2 ± 0.5 cm), and thick corona enhancement was seen in 45 tumors (2.0 ± 0.9 cm). There was a significant difference in tumor diameter between tumors with and those without corona enhancement (P = 0.0157) and between thin and thick corona enhancement (P = 0.001). In all seven early-stage tumors, corona enhancement was demonstrated around the hypervascular focus within the hypovascular tumor portion. None of the nine pseudolesions showed any corona enhancement. Dual-phase CBCTHA depicted corona enhancement in 88.7% of hypervascular HCC lesions. This technique may improve the diagnostic accuracy of HCC.
本研究旨在评估肝动脉造影期间（CBCTHA）使用双相锥形束 CT 检测富血管性肝细胞癌（HCC）周围冠状增强的能力。对 71 个 HCC 病变（平均±SD 1.7±0.9cm）进行双相 CBCTHA 检查，包括 7 个呈结节内结节样外观和 9 个富血管性假性病变。第一扫描是通过肝动脉以 1.5-2ml/s 的速度注射 30-40ml 半稀释造影剂时进行的。在开始注射造影剂后 7s 开始扫描。第二扫描在第一扫描结束后 30s 开始。评估了第二相 CBCTHA 中冠状增强的检测能力。也分析了冠状增强的厚度，分为薄（≤2mm）或厚（>2mm）。在 71 个肿瘤（1.8±0.9cm）中有 63 个（88.7%）检测到冠状增强，但有 8 个（1.0±0.2cm）肿瘤未检测到。在 18 个肿瘤（1.2±0.5cm）中可见薄的冠状增强，在 45 个肿瘤（2.0±0.9cm）中可见厚的冠状增强。有冠状增强和无冠状增强的肿瘤之间（P=0.0157）以及薄冠状增强和厚冠状增强的肿瘤之间（P=0.001）的肿瘤直径有显著差异。在所有 7 个早期肿瘤中，在低血供肿瘤部分内的富血管焦点周围均显示冠状增强。9 个假性病变均无任何冠状增强。双相 CBCTHA 显示 88.7%的富血管性 HCC 病变有冠状增强。该技术可能提高 HCC 的诊断准确性。
