Cho J S, Kwag J G, Oh Y R, Han S D, Song C J
Department of Diagnostic Radiology, Chungnam University Hospital, Taejon, Korea.
J Comput Assist Tomogr. 1996 Jan-Feb;20(1):128-34. doi: 10.1097/00004728-199601000-00024.
Our goal was to assess the effect of dynamic CT during the arterial dominant phase with uniphasic injection of intravenous contrast material (5 ml/s) in the detection and characterization of hepatocellular carcinomas (HCCs).
Three-phase incremental dynamic CT was performed in 66 patients with 84 HCCs diagnosed by pathologic findings, characteristic angiographic findings, and clinical manifestations. One hundred fifty milliliters of nonionic contrast medium was administered intravenously by using a power injector at a flow rate of 5 ml/s for 30 s, and three-phase images were obtained at 20-45 s (arterial dominant phase), 55-80 s (portal venous phase), and 2-4 min (equilibrium phase) after the start of uniphasic intravenous injection. Three-phase images in 66 patients were compared and assessed for the detectability and enhancement pattern of the tumors.
The arterial dominant phase images of dynamic CT showed a moderate to marked hyperattenuation in 73 (87%) of the 84 HCCs, isoattenuation in 6 (7%), and hypoattenuation in 5 (6%). The portal venous phase images showed hyperattenuation in 6 (7%), isoattenuation in 45 (54%), and hypoattenuation in 33 (39%). In the equilibrium phase, CT findings showed hypoattenuation in 67 (80%) and isoattenuation in 17 (20%). The detectability of HCCs in the arterial dominant, portal venous, and equilibrium phase was 93, 46, and 80%, respectively. The detectability of HCCs in the arterial dominant phase was significantly (p < 0.0001) superior to that in both the portal venous phase and the equilibrium phase.
Dynamic CT during the arterial dominant phase with uniphasic injection of intravenous contrast medium (5 ml/s) is a useful method in the detection and characterization of HCCs.
我们的目标是评估在动脉期进行动态CT检查，并以单相静脉注射造影剂（5毫升/秒）来检测和鉴别肝细胞癌（HCC）的效果。
对66例经病理检查、典型血管造影表现及临床表现确诊为84个HCC的患者进行了三期渐进性动态CT检查。使用高压注射器以5毫升/秒的流速静脉注射150毫升非离子型造影剂，持续30秒，并在单相静脉注射开始后的20 - 45秒（动脉期）、55 - 80秒（门静脉期）和2 - 4分钟（平衡期）获取三期图像。对66例患者的三期图像进行比较，评估肿瘤的可检测性和强化模式。
动态CT的动脉期图像显示，84个HCC中有73个（87%）呈中度至明显高密度，6个（7%）呈等密度，5个（6%）呈低密度。门静脉期图像显示6个（7%）呈高密度，45个（54%）呈等密度，33个（39%）呈低密度。在平衡期，CT表现为67个（80%）呈低密度，17个（20%）呈等密度。HCC在动脉期、门静脉期和平衡期的可检测性分别为93%、46%和80%。HCC在动脉期的可检测性显著高于门静脉期和平衡期（p < 0.0001）。
在动脉期进行动态CT检查，并以单相静脉注射造影剂（5毫升/秒）是检测和鉴别HCC的一种有用方法。
