Rengo Marco, Bellini Davide, De Cecco Carlo N, Osimani Marcello, Vecchietti Fabrizio, Caruso Damiano, Maceroni Marco M, Lucchesi Paola, Iafrate Franco, Palombo Erica, Paolantonio Pasquale, Ferrari Riccardo, Laghi Andrea
Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Italy.
Acta Radiol. 2011 Jun 1;52(5):473-80. doi: 10.1258/ar.2011.100500. Epub 2011 Mar 28.
The advent of multidetector computed tomography (MDCT) revolutionized abdominal imaging. In particular, the definitive assessment of CT injection protocols, for the evaluation of the liver parenchyma, is still a critical issue for radiologists. Over the last years, this feature encouraged several authors to address their efforts to find the most accurate delay between the contrast medium injection and the effective scan-start, for the identification and characterization of liver lesions. Technological developments of the present century such as number of slices, submillimetric collimation, and the use of multiple dynamic post-contrast phases per single examination, may all contribute to increase the radiation exposure of single patients. The aim of this review is to propose liver imaging protocols, taking into consideration different clinical needs such as patients with chronic liver disease, healthy patients with focal liver lesion, and oncological patients to minimize radiation exposure. Finally, two recent innovations in MDCT which illustrate the potential application of multi-energy computed tomography (MECT) and perfusion computed tomography (CTp) when evaluating liver parenchyma will be discussed in a short closing paragraph.
多层螺旋计算机断层扫描（MDCT）的出现彻底改变了腹部成像。特别是，对于肝脏实质评估的CT注射方案的明确评估，对放射科医生来说仍然是一个关键问题。在过去几年中，这一特点促使几位作者致力于寻找造影剂注射与有效扫描开始之间最准确的延迟时间，以识别和表征肝脏病变。本世纪的技术发展，如层数、亚毫米级准直以及每次检查使用多个动态造影后阶段，都可能导致单个患者的辐射暴露增加。本综述的目的是提出肝脏成像方案，同时考虑不同的临床需求，如慢性肝病患者、有局灶性肝病变的健康患者和肿瘤患者，以尽量减少辐射暴露。最后，将在简短的结尾段落中讨论MDCT的两项最新创新，它们说明了多能计算机断层扫描（MECT）和灌注计算机断层扫描（CTp）在评估肝脏实质时的潜在应用。
