이중시기 나선 문맥조영 CT : 결정성 간암 진단에서의 유용성 비교

초록

PURPOSE : To assess the value of double-phase(ear1y and late) spiral CT during arterial portography (CTAP) in the detection of nodular hepatocellular carcinoma. MATERIALS AND METHODS : From March to September 1995, 29 patients with nodular hepatocellular carcinoma underwent double-phase spiral CTAP. Spiral CT during hepatic arteriography (CTHA) and Lipiodol CT were obtained for the diagnosis of nodular hepatocellular carcinoma. Early phase spiral CTAP scan started 33~40 seconds after initiation of contrast material injection, and late phase spiral CTAP scan started 15~20 seconds after the end of first spiral scan. Using power injector, 100㎖ of non-ionic contrast material was injected at a rate of 2㎖/sec via superior mesenteric artery. Two radiologists did retrospective analysis by consensus: 1) the number of lesion detection, 2) lesion conspicuity (attenuation value of parenchyma - attenuation value of lesion), and 3) the number and degree of regions of perfusion abnormality on early and late phase CTAP. RESULTS : Total 56 nodular hepatocellular carcinoma from 29 patients were detected on CTHA and/or follow-up Lipiodol CT; 26 of ≥3㎝ in diameter, 15 of ≥1㎝ and<3㎝, and 15 of (1㎝. Fifty-five(98%) lesions were detected on early phase CTAP; 26(100%) of ≥3㎝, 14(93%) of ≥1㎝ and<3㎝, and l5(100%) of <1㎝, and 51(93%) lesions were detected on late phase CTAP; 26(100%) of ≥3㎝, 13(87%) of ≥1㎝ and<3m, and 12(80%) of<1㎝. The average of the lesion conspicuity, examined from 36 scans, was 149.5(± 67.7) HU on early phase CTAP and 72.7(±37.0) HU on late phase CTAP. Twenty-nine perfusion abnormalities from 18 patients were noted on early phase CTAP. Twenty-six regions among 29 perfusion abnormalities were less distinct or absent on late phase CTAP. CONCLUSION : The early phase CTAP was more accurate in the detection of nodular hepatocellular carcinoma and showed more prominent lesion conspicuity as compared with late phase CTAP (p<0.01), although perfusion abnormality was more prominent on early phase CTAP.

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