Ikeda K, Saitoh S, Koida I, Tsubota A, Arase Y, Chayama K, Kumada H
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Hepatology. 1994 Jul;20(1 Pt 1):82-7. doi: 10.1016/0270-9139(94)90137-6.
To elucidate the detectability of small hepatocellular carcinoma by various imaging modalities, we performed digital subtraction angiography, computed tomographic arterioportography and carbon dioxide-enhanced ultrasonography. Of 76 patients with a small hepatocellular carcinoma of 2 cm or less in maximum diameter, 61 underwent digital subtraction angiography, computed tomographic arterioportography and enhanced ultrasonography at the same time. Concerning the 61 patients undergoing all the procedures, the characteristics of hepatocellular carcinoma were found in 57.4% (35 of 61) by digital subtraction angiography, 75.4% (46 of 61) by computed tomographic arterioportography and 72.1% (44 of 61) by enhanced ultrasonography. Among them, four hepatocellular carcinomas were detected only by enhanced ultrasonography, three were diagnosed only by computed tomographic arterioportography and two were diagnosed by both of them. Except for six hemangioma nodules that were easily diagnosed only with angiography, four of 55 benign hepatic nodules (7.3%) showed false-positive findings suggestive of hepatocellular carcinoma with either computed tomographic arterioportography or enhanced ultrasonography. In conclusion, computed tomographic arterioportography and enhanced ultrasonography could complementarily detect a small hepatocellular carcinoma more sensitively than digital subtraction angiography.
为了阐明各种成像方式对小肝细胞癌的检测能力，我们进行了数字减影血管造影、计算机断层动脉门静脉造影和二氧化碳增强超声检查。在76例最大直径为2 cm或更小的小肝细胞癌患者中，61例同时接受了数字减影血管造影、计算机断层动脉门静脉造影和增强超声检查。在接受所有检查的61例患者中，数字减影血管造影发现肝细胞癌特征的比例为57.4%（61例中的35例），计算机断层动脉门静脉造影为75.4%（61例中的46例），增强超声检查为72.1%（61例中的44例）。其中，4例肝细胞癌仅通过增强超声检查发现，3例仅通过计算机断层动脉门静脉造影诊断，2例通过两者诊断。除了6个仅通过血管造影容易诊断的血管瘤结节外，55个良性肝结节中有4个（7.3%）在计算机断层动脉门静脉造影或增强超声检查中显示出提示肝细胞癌的假阳性结果。总之，计算机断层动脉门静脉造影和增强超声检查比数字减影血管造影能更敏感地互补检测小肝细胞癌。
