PMID: 9551526Apr 29, 1998Paper

Two-phase helical hepatic CT. Contrast-injection protocol, optimal timing and its usefulness in clinical cases

Journal of UOEH
R Yoshikawa

Abstract

The usefulness of two-phase helical computed tomography (CT) of the liver was evaluated in clinical cases. First, an optimal scanning protocol was determined using time-attenuation analysis. Monophasic dynamic CT was performed with 100 ml of contrast media (iodine 300 mg/ml) injected either at 3 ml/s or at 2 ml/s. Aortic, hepatic and portal time-attenuation curves were made for each protocol. The results showed that these two different injection protocols produce equivalent enhancements and that the injection rate of 2 ml/s is satisfactorily applicable to clinical cases. The first scanning (arterial phase) must be started 40-45 s after the beginning of the injection of contrast media and the second scanning (delayed phase) 80-120 s after the beginning of injection. Using these CT protocols, 327 cases were examined. In this study 83 hepatic lesions (hepatocellular carcinoma : HCC, n = 29; suspected HCC, n = 30; hemangioma, n = 24) were evaluated. There were 15 HCCs smaller than 30 mm in diameter (71.4%) detected by either arterial phase or delayed phase alone. This result indicates that two-phase helical hepatic CT is very useful in the detection of small HCC. Particularly, four of 5 HCCs of less than 10 mm in size (80%) showed ...Continue Reading

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