Taourel P G, Pageaux G P, Coste V, Fabre J M, Pradel J A, Ramos J, Larrey D, Domergue J, Michel H, Bruel J M
Service d'Imagerie Médicale, Hôpital Saint-Eloi, France.
Radiology. 1995 Nov;197(2):377-80. doi: 10.1148/radiology.197.2.7480680.
To assess computed tomography (CT) with iodized oil for depiction of small hepatocellular carcinoma (HCC) before liver transplantation.
Thirty-five consecutive cirrhotic patients underwent CT with iodized oil to determine the presence, number, size, and location of possible nodules. All patients underwent liver transplantation within 4 months after CT. Explanted livers were cut in 8-mm slices that corresponded to axial CT scan planes. Comparison between CT staging and pathologic findings was made.
Pathologic studies showed 17 HCC nodules (diameter, 0.9-4.0 cm) in nine of the 35 livers. CT depicted nine of these 17 nodules. Lesion-by-lesion analysis revealed a sensitivity of 53%; CT falsely depicted three additional nodules not confirmed with pathologic findings. Patient-by-patient analysis revealed an 89% sensitivity and an 88% specificity.
CT with iodized oil, when assessed lesion by lesion, has a low sensitivity. These results must be considered when liver resection is proposed for HCC.
评估碘油增强计算机断层扫描（CT）在肝移植术前对小肝细胞癌（HCC）的显示情况。
35例连续性肝硬化患者接受碘油增强CT检查，以确定可能存在的结节的数量、大小及位置。所有患者均在CT检查后4个月内行肝移植手术。将切除的肝脏切成与CT轴位扫描层面相对应的8毫米厚切片，对比CT分期与病理结果。
病理研究显示，35例肝脏中的9例存在17个HCC结节（直径0.9 - 4.0厘米）。CT显示出其中的9个结节。逐个病灶分析显示敏感性为53%；CT还误判了3个经病理检查未证实的额外结节。逐个患者分析显示敏感性为89%，特异性为88%。
逐个病灶评估时，碘油增强CT的敏感性较低。在考虑对HCC进行肝切除时，必须考虑这些结果。
