Contrast-enhanced helical CT of the head and neck: improved conspicuity of squamous cell carcinoma on delayed scans.
OBJECTIVE
We evaluated the impact of delayed scans on the conspicuity of squamous cell carcinoma in helical CT of the head and neck.


METHODS
Twenty-seven patients with biopsy-proven squamous cell carcinoma of the head and neck underwent dual-phase helical CT examinations using 100 mL of nonionic contrast material. In all patients, the early phase started 30 sec after the commencement of injection. The patients were assigned to one of two groups in which the delayed phase started either 180 sec (group A, n = 13) or 300 sec (group B, n = 14) after the start of injection. The overall image quality, including vascular opacification and the quality of lesion conspicuity, was determined according to a three-point scoring system.


RESULTS
Overall image quality scored better on the early scans (score, 1.4 +/- 0.5) than on the late scans with a 180-sec (score, 1.6 +/- 0.6; p = 0.03) or a 300-sec delay (score, 2.4 +/- 0.5; p = 0.002). Tumor conspicuity scored better on scans with a 180-sec delay (score, 1.4 +/- 0.5) than on the scans with a 30-sec delay (score, 2.3 +/- 0.7; p = 0.02) or the scans with a 300-sec delay (score, 2.3 +/- 0.7; p = 0.03). In eight (62%) of 13 patients in group A and in six (43%) of 14 patients in group B, the tumor was better delineated on the late scans than on the early scans.


CONCLUSIONS
Although early scans provide optimal vascular enhancement and are therefore necessary for helical CT studies of the head and neck, additional delayed scans may improve lesion detection in patients with squamous cell carcinoma of the head and neck.
Groell
R
R
Department of Radiology, University Hospital Graz, Auenbruggerplatz 9, A-8036 Graz, Austria.
Doerfler
O
O
Schaffler
G J
GJ
Habermann
W
W
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide