Hennedige Tiffany, Yang Zhineng Jayson, Ong Cheng Kang, Venkatesh Sudhakar Kundapur
Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore.
Abdom Imaging. 2014 Dec;39(6):1247-54. doi: 10.1007/s00261-014-0174-1.
To determine the utility of non-contrast-enhanced CT (NC-CT) for improved detection of hyperenhancement in hepatocellular carcinomas (HCC).
We performed a retrospective analysis on CT studies of 104 consecutive patients with 124 HCCs between October 2006 and December 2012. The enhancement of HCC was evaluated on quadriphasic CT: non-contrast (NC), arterial phase (AP), portal-venous phase (PVP), and delayed phases (DP) were performed. For determination of enhancement, mean attenuation of the HCC and surrounding non-tumor bearing liver in the four phases were recorded. Hyperenhancement was defined by either HCC (AP-NC) representing absolute lesion enhancement or AP (HCC-liver), representing relative enhancement. An increase of ≥10 Hounsfield units (HU) was considered as enhancement. Two radiologists (R1 and R2) independently performed a conventional qualitative assessment for hyperenhancement of HCC. The accuracy of detection by proposed absolute lesion enhancement HCC (AP-NC) was compared to relative enhancement AP (HCC-liver) and qualitative assessment by readers with the McNemar test.
The proposed criteria of absolute lesion enhancement, HCC (AP-NC) identified more hypervascular nodules compared to qualitative analysis (92% vs. 62% for R1 and 69% for R2), equating to an improvement of 23%-31%. In contrast, relative enhancement AP (HCC-liver) was found to be inferior to conventional qualitative analysis (50% vs. 62%-69% for readers).
NC-CT is useful to improve the detection of hyperenhancement in HCCs for imaging diagnosis.
确定非增强CT（NC-CT）在提高肝细胞癌（HCC）强化检测中的作用。
我们对2006年10月至2012年12月期间连续104例患有124个HCC的患者的CT研究进行了回顾性分析。在四期CT上评估HCC的强化情况：进行非增强（NC）、动脉期（AP）、门静脉期（PVP）和延迟期（DP）扫描。为了确定强化情况，记录了四个期相中HCC及周围非肿瘤肝脏的平均衰减值。通过HCC（AP-NC）代表绝对病变强化或AP（HCC-肝脏）代表相对强化来定义高强化。≥10亨氏单位（HU）的增加被视为强化。两位放射科医生（R1和R2）独立对HCC的高强化进行传统的定性评估。通过提出的绝对病变强化HCC（AP-NC）的检测准确性与相对强化AP（HCC-肝脏）以及读者的定性评估进行McNemar检验比较。
与定性分析相比，提出的绝对病变强化标准HCC（AP-NC）识别出更多的高血供结节（R1为92%对62%，R2为69%），相当于提高了23%-31%。相比之下，相对强化AP（HCC-肝脏）被发现不如传统定性分析（读者为50%对62%-69%）。
NC-CT有助于提高HCC强化的检测以用于影像诊断。
