Gattoni F, Baldini U, Raiteri R, Pozzato C, De Cobelli F, Uslenghi C
Istituto di Scienze Radiologiche dell'Università, Cattedra di Radiologia dell'Ospedale San Paolo, Milano.
Radiol Med. 1993 Oct;86(4):484-8.
Intra-arterial CT of the liver is a valuable method to evaluate hepatocellular carcinoma (HCC). It consists of an infusion of contrast medium into the hepatic artery during CT scanning. Twelve patients with suspected resectable HCCs were evaluated with CT arteriography before surgery. The results of CT arteriography were compared with those of US, of CT with intravenous contrast medium and of angiography; on the rule, all exams had been performed some days earlier. The diagnosis of HCC was confirmed by US-guided fine-needle biopsy. CT arteriography demonstrated liver lesions in 11 patients. The lesions were hyperdense in 3/11 patients (27.3%) and hypodense and surrounded by a hyperdense ring in 8/11 patients (72.7%). In 4 of 11 patients (36.4%) CT arteriography identified additional tumor nodules and thus surgery was excluded. In the latter cases, on the basis of CT arteriographic findings, US, CT with i.v. contrast medium and angiography were repeated but failed to demonstrate the additional nodules, either because they were too small or because of cirrhotic changes in liver parenchyma. Therefore, CT arteriography is recommended in the evaluation of selected patients, especially when detailed information on liver parenchyma is needed--e.g., before surgery. In these patients CT arteriography can be performed together with preoperative angiography.
肝脏动脉内CT是评估肝细胞癌（HCC）的一种有价值的方法。它包括在CT扫描期间向肝动脉内注入造影剂。12例疑似可切除HCC的患者在手术前接受了CT血管造影评估。将CT血管造影的结果与超声、静脉注射造影剂的CT以及血管造影的结果进行了比较；通常，所有检查均在数天前进行。HCC的诊断通过超声引导下细针穿刺活检得以证实。CT血管造影在11例患者中显示出肝脏病变。在11例患者中有3例（27.3%）病变为高密度，8例（72.7%）病变为低密度且周围有高密度环。在11例患者中有4例（36.4%）CT血管造影发现了额外的肿瘤结节，因此排除了手术。在后者的病例中，基于CT血管造影的结果，重复进行了超声、静脉注射造影剂的CT以及血管造影，但未能显示出额外的结节，要么是因为它们太小，要么是因为肝实质的肝硬化改变。因此，建议在对选定患者进行评估时采用CT血管造影，尤其是在需要有关肝实质的详细信息时——例如，在手术前。在这些患者中，CT血管造影可与术前血管造影一起进行。
