Choi B I, Lee H J, Han J K, Choi D S, Seo J B, Han M C
Department of Radiology, Seoul National University College of Medicine and Hospital, Korea.
AJR Am J Roentgenol. 1997 Jan;168(1):219-24. doi: 10.2214/ajr.168.1.8976949.
The objective of this study was to compare the capability of arterial, portal venous, and delayed phases of helical CT with that of iodized-oil CT for revealing nodular hepatocellular carcinomas.
Forty-eight patients with nodular hepatocellular carcinomas underwent triphasic helical CT examination with 10-mm collimation at 10-mm/sec table speed. We injected 120 ml of contrast material (36 g of iodine) at the rate of 3 ml/sec. Arterial-phase, portal venous-phase, and delayed-phase images were obtained with 30-sec, 65-sec, and 360-sec delays, respectively. All 48 patients also underwent angiography and intraarterial infusion of iodized oil after helical CT; iodized-oil CT was performed about 2 weeks after infusion of iodized oil. Helical CT images were compared with iodized-oil CT images for revealing hepatic nodules.
In 48 patients, 79 hepatocellular carcinomas were seen with iodized-oil CT. Using helical CT, the arterial phase revealed 68 lesions (86%), the portal venous phase revealed 53 lesions (67%), and the delayed phase revealed 57 lesions (72%). The arterial phase proved superior to the portal venous and delayed phases for revealing lesions (p = .0025). The portal venous phase showed no significant difference for revealing lesions compared with the delayed phase. When combined, helical CT of the arterial and portal venous phases revealed 73 lesions (92%); a combination of the arterial and delayed phases revealed 72 lesions (91%); and a combination of the portal venous and delayed phases revealed 63 lesions (80%). Any combination of two phases that included the arterial phase proved superior to the combination of the portal venous and delayed phases (p = .0033). Overall, the combination of the arterial and portal venous phases (92%) or the combination of all three phases (92%) proved best at revealing lesions.
The arterial phase of helical CT is better for revealing nodular hypervascular hepatocellular carcinoma than are the portal venous and delayed phases. The combination of the arterial and portal venous phases is superior to the arterial phase alone. Also, the combination of the arterial and portal venous phases is equal to the combination of the three phases for revealing hypervascular hepatocellular carcinomas.
本研究的目的是比较螺旋CT动脉期、门静脉期和延迟期与碘油CT显示结节性肝细胞癌的能力。
48例结节性肝细胞癌患者接受了螺旋CT三相检查，准直为10mm，床速为10mm/秒。以3ml/秒的速率注入120ml造影剂（36g碘）。分别在延迟30秒、65秒和360秒时获得动脉期、门静脉期和延迟期图像。所有48例患者在螺旋CT检查后还接受了血管造影和动脉内碘油灌注；在注入碘油约2周后进行碘油CT检查。比较螺旋CT图像和碘油CT图像以显示肝结节。
48例患者中，碘油CT显示79个肝细胞癌。使用螺旋CT，动脉期显示68个病灶（86%），门静脉期显示53个病灶（67%），延迟期显示57个病灶（72%）。动脉期在显示病灶方面优于门静脉期和延迟期（p = 0.0025）。门静脉期与延迟期在显示病灶方面无显著差异。动脉期和门静脉期的螺旋CT联合显示73个病灶（92%）；动脉期和延迟期联合显示72个病灶（91%）；门静脉期和延迟期联合显示63个病灶（80%）。包括动脉期的任意两期联合均优于门静脉期和延迟期联合（p = 0.0033）。总体而言，动脉期和门静脉期联合（92%）或三期联合（92%）在显示病灶方面效果最佳。
螺旋CT动脉期在显示结节性富血管肝细胞癌方面优于门静脉期和延迟期。动脉期和门静脉期联合优于单独的动脉期。此外，动脉期和门静脉期联合在显示富血管肝细胞癌方面与三期联合相当。
