Abstract
The aim of this study was to clarify the clinical usefulness of combined CT during arterial portography (CTAP), and CT arteriography (CTA), for the diagnosis of hepatocellular carcinoma. CTAP and CTA were performed in 58 patients with a combined 144 hepatocellular carcinoma (HCC) lesions. Arterial vascular access was obtained through bilateral punctures of the femoral artery with selective placement of catheters in the hepatic artery and superior mesenteric artery. CT scans were performed first during injection of contrast media into the superior mesenteric artery, followed by repeated imaging of the liver during injection of contrast media into the hepatic artery. Delayed CT (DCT) was also obtained 5 min after CTA. The detection rates for all 144 lesions were 73.6% with conventional contrast enhanced CT, 90.3% with CTAP, 95.8% with CTA, 87.5% with DCT, and 98.6% with combined CTAP and CTA. Of early HCC lesions (n = 18), 88.9%, 33.3%, 77.8%, 100%, and 88.9% were detected by conventional contrast enhanced CT, CTAP, CTA, DCT, and combined CTAP and CTA, respectively. Of classical HCC lesions (n = 126), 71.4%, 98.4%, 98.4%, 85.7%, and 100% were detected by conventional contrast enhanced CT, CTAP, CTA, DCT, and combined CTAP and CTA, respectively. Combining CTAP and CTA improved the radiologist's ability to detect lesions with confidence and to differentiate perfusion abnormalities of HCCs.
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