Department of Interventional Radiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2018 Oct 20;131(20):2410-2416. doi: 10.4103/0366-6999.243554.
The diagnosis and treatment of small hepatocellular carcinoma (HCC) play a vital role in the prognosis of patients with HCC. The purpose of our study was to evaluate angio-computed tomography (angio-CT)-guided immediate lipiodol CT (a CT scan performed immediately after transarterial chemoembolization [TACE]) in the diagnosis of potential HCCs ≤1 cm in diameter.
This study retrospectively analyzed 31 patients diagnosed with HCCs after routine imaging (contrast-enhanced CT or magnetic resonance imaging) or pathologic examinations with undefined or undetermined tumor lesions (diameter ≤1 cm) from February 2016 to September 2016. After TACE guided by digital subtraction angiography of the angio-CT system, potential HCC lesions with a diameter ≤1 cm were diagnosed by immediate lipiodol CT. The number of well-demarcated lesions was recorded to calculate the true positive rate. The correlation between the number of small HCCs detected by immediate lipiodol CT and the size of HCC lesions (diameter >1 cm) diagnosed preoperatively was analyzed 1 month after TACE. A paired t-test was used to analyze differences in liver function. Pearson analysis was used to analyze correlation. Chi-square test was used to compare the rates.
Fifty-eight lesions were detected on preoperative routine imaging examinations in 31 patients including 15 lesions with a diameter ≤1 cm. Ninety-one lesions were detected on immediate lipiodol CT, of which 48 had a diameter ≤1 cm. After 1 month, CT showed that 45 lesions had lipiodol deposition and three lesions had lipiodol clearance. Correlation analysis showed that the number of small HCCs detected by lipiodol CT was positively correlated with the size of HCC lesions diagnosed by conventional imaging examination (R = 0.54, P < 0.05).
Immediate lipiodol CT may be a useful tool in the diagnosis of potential HCC lesions with a diameter of ≤1 cm.
小肝细胞癌（HCC）的诊断和治疗对 HCC 患者的预后起着至关重要的作用。本研究的目的是评估血管计算机断层扫描（angio-CT）引导的即刻碘化油 CT（TACE 后立即进行的 CT 扫描）在诊断直径≤1cm 的潜在 HCC 中的作用。
本研究回顾性分析了 2016 年 2 月至 2016 年 9 月期间，经常规影像学（增强 CT 或磁共振成像）或病理检查诊断为 HCC 后，有定义不明确或未确定肿瘤病变（直径≤1cm）的 31 例患者。在数字减影血管造影 angio-CT 系统引导下行 TACE 后，用即刻碘化油 CT 诊断直径≤1cm 的潜在 HCC 病变。记录清晰显示病变的数量以计算真阳性率。分析 TACE 后 1 个月，即刻碘化油 CT 检测的小 HCC 数量与术前诊断的 HCC 病变（直径>1cm）大小之间的相关性。采用配对 t 检验分析肝功能差异，采用 Pearson 分析相关性，采用卡方检验比较发生率。
31 例患者术前常规影像学检查发现 58 个病灶，其中 15 个病灶直径≤1cm。即刻碘化油 CT 发现 91 个病灶，其中 48 个病灶直径≤1cm。1 个月后 CT 显示 45 个病灶有碘化油沉积，3 个病灶有碘化油清除。相关性分析显示，碘化油 CT 检测到的小 HCC 数量与常规影像学检查诊断的 HCC 病变大小呈正相关（R=0.54，P<0.05）。
即刻碘化油 CT 可能是诊断直径≤1cm 的潜在 HCC 病变的有用工具。
