title: Hepatic computed tomography for simultaneous depiction of hepatocellular carcinoma, intrahepatic portal veins, and hepatic veins in real-time virtual sonography: initial experience.
abstract: OBJECTIVE
  The aim of this study was to examine a double-step injection of contrast material in hepatic computed tomography (CT) for the simultaneous depiction of hepatocellular carcinoma (HCC), intrahepatic portal veins, and hepatic veins in real-time virtual sonography.
  
  
  METHODS
  This study consisted of 6 patients with solitary HCC nodules with early enhancement on dynamic contrast-enhanced CT. Computed tomographic scanning was performed in a combined late arterial/hepatic phase after 2 sequential contrast material injections.
  
  
  RESULTS
  In all 6 patients, the solitary HCC nodule, intrahepatic portal veins, and hepatic veins were simultaneously visualized with enhancement, for which CT values were appreciably higher than that of the liver parenchyma. In virtual sonography, HCC nodules and intrahepatic vessels were simultaneously shown, and the HCC lesions were treated by radio frequency ablation without vascular injury.
  
  
  CONCLUSIONS
  A double-step injection of contrast material in hepatic CT was helpful in the identification of the relationship between the HCC nodule and intrahepatic vessels under virtual sonography and contributed to the accurate and safe performance of radio frequency ablation for HCC.
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka, Japan. sa104@rg8.so-net.ne.jp
authors.forename: Fuminari
authors.initials: F
authors.lastname: Tatsugami
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Matsuki
authors.forename: Go
authors.initials: G
authors.lastname: Nakai
authors.forename: Masato
authors.initials: M
authors.lastname: Tanikake
authors.forename: Shushi
authors.initials: S
authors.lastname: Yoshikawa
authors.forename: Isamu
authors.initials: I
authors.lastname: Narabayashi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Miyaji
authors.forename: Akira
authors.initials: A
authors.lastname: Asai
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hongo
authors.forename: Kenichi
authors.initials: K
authors.lastname: Katsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000601:surgery; D017115:Catheter Ablation; D003287:Contrast Media; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging*; D006801:Humans; D007472:Iohexol; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography; D014584:User-Computer Interface
chemical_list: D003287:Contrast Media; D007472:Iohexol