Contrast Enhancement Patterns of Hepatic Masses using Three Phase Spiral CT

Ko, Sung Min; Park, Joong Wha; Lee, Chang Man; Kim, Sung Min; Kim, Ik Soo; Kim, Dong Jin; Hong, In Soo

Abstract

PURPOSE
To compare the contrast enhancement patterns of hepatocellular carcinomas(HCCs), hemangiomas, and metastases on three-phase images with spiral CT for differential diagnosis.
MATERIALS AND METHODS
Three-phasespiral CT scan was performed in 73 patients with hepatic masses. CT scanning was performed with a table speed of 10mm/sec, section thickness of 10mm, and a reconstruction interval of 5mm, 100-150ml of contrast medium was injected intravenously with an automatic injector at a rate of 2-3mL/sec. CT scans were obtained at 30, 70 and 180 seconds after the start of contrast material injection.
RESULTS
The enhancement patterns of 136 lesions in 53 patients with HCCs were as follows : 47 lesions(35%) were totally high and 55(40%) were mixed in the early phase ;30 lesions(22%) were mixed and 66(49%) were totally low in the portal phase ; and 105 lesions(78%) were totally low in the delayed phase. In hemangiomas of 23 lesions in 15 patients, 7 lesions(30%) were peripherally high and11(48%) were totally low in the arterial phase ; 4 lesions(17%) were totally high and 12(53%) were peripherally high in the portal phase ; 10 lesions(42%) were totally high and 4(18%) were peripherally high in the deayed phase. In metastatic liver mali gnancies of 42 lesions in 5 patients, 13 lesions(31%) were peripherally high and 22(52%) were totally low in the arterial phase ; 32 lesions(77%) were totally low in the portal phase, and 35(83%)were totally low in the delayed phase.
CONCLUSION
Three-phase spiral CT scanning is a useful diagnostic methodin the differential diagnosis of hepatic masses including HCCs, hemangiomas, and hepatic metastases.