Multi-phasic CT arterial portography and CT hepatic arteriography improving the accuracy of liver ca

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AIM:To evaluate the value of multi-phasic CT arterialportography(CTAP)and CT hepatic arteriography(CTHA)in differential diagnosis of liver diseases,and to improvethe specificity of CTAP and CTHA for liver cancerdetection.METHODS:From January 1999 to December 2002,multi-phasic CTAP and CTHA were performed in 20 patientswith suspected liver disease.CT scanning was begun 25 s,60 s and 120 s for the early,late- and delayed-phase CTAPexaminations,and 6sec,40 s and 120 s for the early-,late-and delayed-phase CTHA examinations respectively,after atranscatheter arterial injection of non-ionic contrast material.If a lesion was diagnosed as a liver cancer,transcatheterhepatic arterial chemoembolization(TACE)treatment wasperformed,and the follow-up CT was performed three orfour weeks later.RESULTS:All eighteen HCCs in 12 cases were shown asnodular enhancement on early-phasic CTHA.The densityof the whole tumor decreased rapidly on late and delayedphases,and the edge of 12 tumors(12/18)remainedrelatively hyperdense compared with the surrounding livertissue,and demonstrated as rim enhancement.All HCCswere shown as perfusion defect nodules on multi-phasicCTAP.Five tumors(5/18)were shown as rim enhancementon delayed-phasic CTAP.Rim enhancement was shown as1 to 2-mm-wide irregular,uneven and discontinuouscircumferential enhancement at late-,and delayed-phaseof CTHA or CLAP.Five pseudolesions and 4 hemoangiomaswere found in multi-phasic ClAP and CTHA.No pseudolesionsand hemoangiomas were shown as rim enhancement onlate- or delayed-phasic CTHA and CTAP.CONCLUSION:Multi-phasic CTAP and CTHA could help torecognize the false-positive findings in CTAP and CTHAimages,and improve the accuracy of CTAP and CTHA ofliver cancer detection.Li L,Liu Z,Xie ZM,Mo YX,Zheng L,Ruan CM,Chen L,WuPH.Multi-phasic CT arterial portography and CT hepaticarteriography improving the accuracy of liver cancer detection.World J Gastroenterol 2004;10(21):3118-3121http://www.wjgnet.com/1007-9327/10/3118.asp 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 cancer detection. METHODS: From January 1999 to December 2002, Multi-phasic CTAP and CTHA were performed in 20 patients with suspected liver disease. CT scanning was begun 25 s, 60 s and 120 s for the early, late- and delayed-phase CTAPexaminations, and 6 sec, 40 s and 120 s for the early -, late-and delayed-phase CTHA examinations respectively, after atranscatheter arterial injection of non-ionic contrast material. If a lesion was diagnosed as a liver cancer, transcatheterhepatic arterial chemoembolization (TACE) treatment was performed, and the follow-up CT was performed three orfour weeks later .RESULTS: All eighteen HCCs in 12 cases were showed as nodular enhancement on early-phasic CTHA.The densityof the whole tumor was rapidly on late and delayedphases, and the edge of 12 tumors (12/18) remainedrela tively hyperdense compared with the surrounding livertissue, 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 as1 to 2 -mm-wide irregular, uneven and discontinuous circularferential enhancement at late-, and delayed-phase of CTHA or CLAP. FIVE pseudolesions and 4 hemoangiomaswere found in multi-phasic ClAP and CTHA. No pseudolesions and hemoangiomas were shown as rim enhancement onlate- or delayed-phasic CTHA and CTAP.CONCLUSION: Multi-phasic CTAP and CTHA could help torecognize the false-positive findings in CTAP and CTHAimages, and improve the accuracy of CTAP and CTHA ofliver cancer detection. Li Liu, Liu Z, Xie ZM, Mo YX, Zheng L, Ruan CM, Chen L, WuPH. Multi-phasic CT arterial portography and CT hepaticarteriography improving the accuracy of liver cancer detection. World J Gastroenterol 2004; 10 (21): 3118-3121 http: //www.wjgnet.com/1007 -9327 / 10 / 3118.asp
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