Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, Johns Hopkins Hospital, Baltimore, MD, USA.
Cardiovasc Intervent Radiol. 2012 Feb;35(1):97-104. doi: 10.1007/s00270-011-0118-x. Epub 2011 Feb 17.
To evaluate the sensitivity of dual-phase cone-beam computed tomography during hepatic arteriography (CBCTHA) for the detection of hepatocellular carcinoma (HCC) by comparing it with the diagnostic imaging "gold standard": contrast-enhanced magnetic resonance imaging (CE-MRI) of the liver.
Eighty-eight HCC lesions (mean diameter 3.9 ± 3.3 cm) in 20 patients (13 men, mean age 61.4 years [range 50 to 80]), who sequentially underwent baseline diagnostic liver CE-MRI and then underwent early arterial- and delayed portal venous-phase CBCTHA during drug eluting-bead transarterial chemoembolization, were evaluated. Dual-phase CBCTHA findings of each tumor in terms of conspicuity were compared with standard CE-MR images and classified into three grades: optimal, suboptimal, and nondiagnostic.
Seventy-seven (mean diameter 4.2 ± 3.4 cm [range 0.9 to 15.9]) (93.9%) of 82 tumors were detected. Sensitivity of arterial-phase (71.9%) was lower than that of venous-phase CBCTHA (86.6%) for the detection of HCC lesions. Of the 82 tumors, 33 (40.2%) and 52 (63.4%), 26 (31.7%) and 19 (23.2%), and 23 (28%) and 11 (13.4%) nodules were classed as optimal, suboptimal, and nondiagnostic on arterial- and venous-phase CBCTHA images, respectively. Seventeen (73.9%) of the 23 tumors that were not visible on arterial phase were detected on venous phase. Six (54.5%) of the 11 tumors that were not visible on venous phase were detected on arterial phase.
Dual-phase CBCTHA has sufficient image quality to detect the majority of HCC lesions compared with the imaging "gold standard": CE-MRI of the liver. Moreover, dual-phase CBCTHA is more useful and reliable than single-phasic imaging to depict HCC nodules.
通过与诊断成像的“金标准”——肝脏对比增强磁共振成像（CE-MRI）进行比较，评估肝动脉造影期间双能锥形束 CT（CBCTHA）检测肝细胞癌（HCC）的敏感性。
20 名患者（男 13 名，平均年龄 61.4 岁[50 至 80 岁]）的 88 个 HCC 病变（平均直径 3.9±3.3cm）连续进行基线诊断性肝 CE-MRI 检查，然后在药物洗脱微球经动脉化疗栓塞期间进行早期动脉期和延迟门静脉期 CBCTHA。比较每个肿瘤在双能锥形束 CT 肝动脉造影的显影方面的双期 CBCTHA 表现，并分为 3 个等级：优、良、差。
77 个（平均直径 4.2±3.4cm[0.9 至 15.9]）（93.9%）肿瘤被检出。动脉期（71.9%）的 HCC 病变检出率低于门静脉期 CBCTHA（86.6%）。在 82 个肿瘤中，动脉期和门静脉期 CBCTHA 图像分别有 33 个（40.2%）和 52 个（63.4%）、26 个（31.7%）和 19 个（23.2%）、23 个（28%）和 11 个（13.4%）肿瘤被归类为优、良和差。23 个在动脉期未见的肿瘤中有 17 个（73.9%）在门静脉期被检出。11 个在门静脉期未见的肿瘤中有 6 个（54.5%）在动脉期被检出。
与肝脏对比增强磁共振成像的“金标准”相比，双能锥形束 CT 肝动脉造影具有足够的图像质量来检测大多数 HCC 病变。此外，双相 CBCTHA 比单相成像更有用和可靠，更能描绘 HCC 结节。
