J Korean Radiol Soc.  1996 Dec;35(6):905-910.

Triple Phase Spiral CT Findings of Hepatocellular Carcinoma

• Kim HI
• Jung MH
• Kim HS
• Park CM
• Cha IH
• Chung KB

Abstract

PURPOSE
To evaluate contrast enhancement patterns of hepatomas (HCCs) on arterial dominant, portal dominant,and delayed phase of CT scan by using double spiral CT.
MATERIALS AND METHODS
Using double-spiral CT, three-phase dynamic liver scan was performed on 27 patients with 45 nodular HCC lesions. Non-ionic contrast medium(100-120ml) was injected intravenously with an automatic injector at the rate of 2-4 ml/sec. CT scans were obtained at 25-30sec (arterial dominant phase), 60 sec (portal dominant phase), and 5min (delayed phase) afteradministration of the contrast medium. The tumor were divided into two groups according to the diameter(<3cm and > or = 3cm). In each group, contrast enhancement patterns of HCCs were classified as follows : high, central high, peripheral high, iso, low, or mixed attenuation. The incidence and contrast enhancement patterns of thin peripheral rims(psevdocapsules) were also analyzed.
RESULTS
There were 23 lesions with a diameter less than 3cm,while 22 lesions were 3cm or larger. On the arterial dominant phase, tumors smaller than 3cm showed high(74%), iso(17%), mixed(4%), and peripheral high(4%) attenuation, while the attenuation of tumors larger than 3cm washigh(73%), mixed(9%), iso(9%), and low(9%). On the portal dominant phase, tumors smaller than 3cm were mostcommonly iso(43%) or high(35%), while tumors larger than 3cm were low(65%) or iso(18%). On the delayed phase, tumors were most commonly low in attenuation regardless of size. A thin peripheral rim was observed in 22% of tumors smaller than 3cm and in 64% of tumors larger than 3cm. The rim showed iso(53%) or low(42%) attenuation onthe arterial dominant phase, high(47%) or iso(47%) attenuation on the portal dominant phase, and high(100%) attenuation on the delayed phase.
CONCLUSIONS
For the detection and diagnois of HCCS, an understanding of their contrast enhancement patterns is useful.

Keyword

Computed tomography(CT), helical; Liver neoplasms, CT

MeSH Terms

Carcinoma, Hepatocellular*
Humans
Incidence
Liver
Tomography, Spiral Computed*
Tomography, X-Ray Computed