Evaluation of the vascular pattern of hepatocellular carcinoma with dynamic computed tomography and its use in identifying optimal temporal windows for helical computed tomography

European Radiology
C M PacellaZ Rossi

Abstract

The aim of this work was to study the vascularization of hepatocellular carcinoma (HCC) by means of dynamic CT and to demonstrate the existence of optimal temporal windows for visualization of HCC in order to develop new protocols for helical CT of the liver. We studied, by means of dynamic CT, 42 histologically proved HCCs in 30 patients after injecting contrast medium (100 ml, 3 ml/s). We performed a time-density analysis of the aorta, liver, portal vein, spleen and lesion. We identified three temporal curves of attenuation of the neoplastic tissue. Curve 1 was three-phasic: hyperattenuation, isoattenuation and hypoattenuation; curve 2 was two-phasic: hyperattenuation and isoattenuation; curve 3 was two-phasic: isoattenuation and hypoattenuation. Thirty-two lesions were homogeneous (curve 1 in 22 cases, 68.7 %; curve 2 in 7 cases, 21.8 %; curve 3 in 3 cases, 9.4 %), whereas 10 lesions were non-homogeneous. Two optimal temporal windows were identified: the first, with predominantly hyperattenuating lesions (range 29-65 s, 90.4 % sensitivity); the second, with predominantly hypoattenuating lesions (range 132.1-360 s, 76.1 %). There is an interposed time range of reduced visualization (range 62-127 s, 54.7 %) in which lesions ar...Continue Reading

Citations

Aug 5, 2014·Magnetic Resonance Imaging Clinics of North America·Daniel C Barr, Hero K Hussain
May 3, 2011·Journal of Vascular and Interventional Radiology : JVIR·Stephan ClasenPhilippe L Pereira
Apr 1, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Claudio Maurizio PacellaRoberto Stasi
May 17, 2006·European Journal of Gastroenterology & Hepatology·Francesco Saverio FerrariFabrizio Magnolfi
Jan 10, 2003·Nihon Hoshasen Gijutsu Gakkai zasshi·Shuji YamamotoShohzoh Nakanishi
Apr 3, 2014·Topics in Magnetic Resonance Imaging : TMRI·Daniel C Barr, Hero K Hussain

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