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Multi-phasic ct arterial portography and ct hepatic arteriography improving the accuracy of liver cancer detection

World Journal of Gastroenterology 2004年第21期10卷 3118-3121页

作者： LiLi Li-ZhiLiu Zhuan-MiaoXie Yun-XianMo LieZheng Chao-MeiRuan LinChen Pei-HongWu ImagingDiagnosis&InterventionalCenter CancerCenterSunYat-senUniversity.651DongfengRoadEastGuangzhou510060.GuangdongProvinceChina

AIM: To evaluate the value of multi-phasic ct arterial portography (ctAP) and ct hepatic arteriography (ctHA) in differential diagnosis of liver diseases, and to improve the specificity of ctAP and ctHA for liver cancerdetection. METHODS: From January 1999 to December 2002, multiphasic ctAP and ctHA were performed in 20 patients with suspected liver disease. ct scanning was begun 25s, 60s and 120s for the early-, late- and delayed-phase ctAP examinations, and 6sec, 40 s and 120 s for the early-, lateand delayed-phase ctHA examinations respectively, after a transcatheter arterial injection of non-ionic contrast material. If a lesion was diagnosed as a liver cancer, transcatheter hepatic arterial chemoembolization (TACE) treatment was performed, and the follow-up ct was performed three or four weeks ***: All eighteen HCCs in 12 cases were shown as nodular enhancement on early-phasic ctHA. The density of the whole tumor decreased rapidly on late and delayed phases, and the edge of 12 tumors (12/18) remained relatively hyperdense compared with the surrounding liver tissue, and demonstrated as rim enhancement. All HCCs were shown as perfusion defect nodules on multi-phasic ctAP. Five tumors (5/18) were shown as rim enhancement on delayed-phasic ctAP. Rim enhancement was shown as 1 to 2-mm-wide irregular, uneven and discontinuous circumferential enhancement at late-, and delayed-phase of ctHA or ctAP. Five pseudolesions and 4 hemoangiomas were found in multi-phasic ctAP and ctHA. No pseudolesions and hemoangiomas were shown as rim enhancement on late- or delayed-phasic ctHA and ***: Multi-phasic ctAP and ctHA could help to recognize the false-positive findings in ctAP and ctHA images, and improve the accuracy of ctAP and ctHA of liver cancer detection.

关键词：多形ct 门静脉造影术动脉肝动脉精确性肝癌肿瘤 ctHA 消化系统

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