Detection of hypervascular hepatocellular carcinoma by using spiral volumetric CT: comparison of US and MR imaging.
BACKGROUND
Most hepatocellular carcinomas (HCCs) are hypervascular and arise in the liver with chronicity. Spiral volumetric CT (SVCT) is a new rapid-scan technique that offers whole-liver scanning during the arterial-dominant phase. The main aim of the present study is to evaluate the detectability of hypervascular HCC with SVCT as compared with ultrasonography (US) and magnetic resonance (MR) imaging.


METHODS
Forty-three hypervascular HCCs in 512 patients with chronic liver disease were examined with US, precontrast SVCT, postcontrast SVCT during the arterial-dominant phase (CT-ADP) and during the equivalent-phase (CT-EP) noncontrast MR imaging and angiography including SVCT during arteriography and arterial portography. Angiographic and follow-up findings were used as the gold standard if the lesion was not confirmed histologically.


RESULTS
The sensitivity was 61% with precontrast CT, 84% with CT-ADP, 58% with CT-EP, 70% with US, 72% with MR, and 95% with the combination of these five modalities. Five HCCs (12%) were detected with only CT-ADP. The vascularity of HCC was correctly evaluated as hypervascular in 38 nodules (88%) with the combination of precontrast CT and CT-ADP.


CONCLUSIONS
We suggest that the combination of precontrast SVCT and CT-ADP is an essential modality to screen for HCC in patients with chronic liver disease. CT-EP did not contribute to the detection of hypervascular HCC.
Ueda
K
K
Department of Radiology, Kanazawa University School of Medicine, Japan.
Kitagawa
K
K
Kadoya
M
M
Matsui
O
O
Takashima
T
T
Yamahana
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001783:Blood Flow Velocity / Q000502:physiology; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply; D008113:Liver Neoplasms / Q000098:blood supply* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*