Department of Radiology, Kinki University School of Medicine, Osakasayama City, Osaka 589-8511, Japan.
Eur J Radiol. 2012 Nov;81(11):2978-83. doi: 10.1016/j.ejrad.2012.01.016. Epub 2012 Feb 2.
The purpose of this study is to prospectively investigate the optimal dose of contrast medium for the depiction of hypervascular hepatocellular carcinoma (HCC) during the hepatic arterial phase (HAP), portal venous phase (PVP) and delayed phase (DP) of dynamic MDCT.
The study included 128 patients, out of these patients, 36 patients were found to have 56 hypervascular HCCs. Sixty-three patients were assigned to receive a dose of 525 mgI/kg with protocol A, and 62 received a dose of 630 mgI/kg with protocol B. Measurements of the attenuation values of the abdominal aorta, portal vein, hepatic vein, hepatic parenchyma and HCC during the HAP, PVP and DP were taken. Tumor-liver contrast (TLC) was calculated from the attenuation value of the hepatic parenchyma and HCC.
The aortic attenuation value with protocol B (351, 166, and 132 HU) was significantly higher than that with protocol A (313, 153, and 120 HU) during all the phases, (P<0.01 for all phases). The hepatic enhancement from unenhanced baseline with protocol B (25.2, 63.6, 50.6 HU) was significantly higher than that with protocol A (20.2, 55.1 and 43.0 HU) during all the phases, (P<0.01 for all phases). The TLC with protocol B (37.4, -11.8 and -13.6 HU) was significantly higher than that with protocol A (28.0, -9.8 and -12.1 HU) during HAP (P=0.042).
The administration of 630 mgI/kg of body weight depicts hypervascular HCC more clearly during HAP and shows sufficient hepatic enhancement of 50 HU during DP.
本研究旨在前瞻性地研究动态 MDCT 肝动脉期（HAP）、门静脉期（PVP）和延迟期（DP）中用于描绘富血管性肝细胞癌（HCC）的最佳对比剂剂量。
本研究纳入了 128 例患者，其中 36 例患者发现有 56 个富血管性 HCC。63 例患者被分配接受方案 A 的 525mgI/kg 剂量，62 例患者接受方案 B 的 630mgI/kg 剂量。在 HAP、PVP 和 DP 期间，对腹主动脉、门静脉、肝静脉、肝实质和 HCC 的衰减值进行了测量。从肝实质和 HCC 的衰减值计算肿瘤-肝对比（TLC）。
方案 B 的主动脉衰减值（351、166 和 132HU）在所有阶段均显著高于方案 A（313、153 和 120HU）（所有阶段 P<0.01）。方案 B 的无增强基线肝强化（25.2、63.6、50.6HU）在所有阶段均显著高于方案 A（20.2、55.1 和 43.0HU）（所有阶段 P<0.01）。方案 B 的 TLC（37.4、-11.8 和-13.6HU）在 HAP 期间显著高于方案 A（28.0、-9.8 和-12.1HU）（P=0.042）。
630mgI/kg 的体质量给药方案在 HAP 期间更清晰地描绘富血管性 HCC，并在 DP 期间显示出足够的 50HU 的肝强化。
