Paulson E K, McDermott V G, Keogan M T, DeLong D M, Frederick M G, Nelson R C
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Radiology. 1998 Jan;206(1):143-50. doi: 10.1148/radiology.206.1.9423664.
To evaluate triple-phase helical computed tomography (CT) of carcinoid liver metastases.
Triple-phase helical CT was performed in 31 patients with proved carcinoid liver metastases. Hepatic arterial-dominant phase (HAP) and portal venous-dominant phase (PVP) images were obtained 20 and 70 seconds after intravenous iopamidol injection. Four independent readers reviewed each phase for lesion number, conspicuity, and attenuation relative to liver. Three readers reviewed each phase to determine which phase best showed the lesions.
The lesions detected by readers 1-4 were as follows: noncontrast phase, 164, 177, 204, and 229 lesions; HAP, 178, 177, 214, and 238 lesions; and PVP, 180, 189, 215, and 250 lesions (P > .05). On HAP images, readers found that 80, 73, 96, and 102 lesions were hyperattenuating. Consensus indicated there were 206 focal lesions. Of these 206 lesions, 72, 72, and 62 lesions were best seen on the noncontrast phase, HAP, and PVP images, respectively. Six, 28, and six lesions were seen only on the noncontrast phase, HAP, and PVP images, respectively. Two patients had lesions seen only on the HAP images.
The HAP and, to a lesser extent, the noncontrast phase provide added value in evaluating carcinoid liver metastasis.
评估类癌肝转移的三期螺旋计算机断层扫描（CT）。
对31例经证实有类癌肝转移的患者进行三期螺旋CT检查。静脉注射碘帕醇后20秒和70秒分别获取肝动脉期（HAP）和门静脉期（PVP）图像。四位独立阅片者对各期图像的病灶数量、清晰度及相对于肝脏的密度进行评估。三位阅片者判断哪一期图像对病灶的显示最佳。
阅片者1 - 4检测到的病灶数量如下：平扫期分别为164、177、204和229个病灶；肝动脉期分别为178、177、214和238个病灶；门静脉期分别为180、189、215和250个病灶（P > 0.05）。在肝动脉期图像上，阅片者发现分别有80、73、96和102个病灶呈高密度。经共识确定有206个局灶性病灶。在这206个病灶中，平扫期、肝动脉期和门静脉期图像上分别最佳显示72、72和62个病灶。仅在平扫期、肝动脉期和门静脉期图像上分别发现6、28和6个病灶。两名患者的病灶仅在肝动脉期图像上可见。
肝动脉期以及在较小程度上平扫期在评估类癌肝转移中具有额外价值。
