MDCT of Hypervascular Hepatocellular Carcinomas: A Prospective Study Using Contrast Materials with Different Iodine Concentrations

Abstract

The objective of our study was to investigate the effect of different iodine concentrations in contrast materials on the depiction of hypervascular hepatocellular carcinomas (HCCs) by MDCT. This prospective study involved 100 consecutive patients with chronic liver disease, including 27 patients with hypervascular HCCs. The first 50 patients received 100 mL of iopamidol at a concentration of 370 mg I/mL (group A) and the subsequent 50, 100 mL at 300 mg I/mL (group B); in both groups, the contrast material was administered at a rate of 3.0 mL/sec. Unenhanced scanning and four-phase enhanced scanning at 25, 40, 60, and 180 sec after the start of contrast injection were performed. The enhancement of the aorta, liver, and portal vein was measured during each phase. In addition, tumor-to-liver contrast was calculated for the 27 patients with hypervascular HCCs. Of the 27 patients with hypervascular HCCs, 15 were in group A and 12 were in group B. During all phases, aortic enhancement was significantly greater in group A than group B (p < 0.01). Hepatic enhancement was significantly greater in group A than group B at 60 and 180 sec (both p < 0.01). There was no significant difference in hepatic enhancement between the two groups at 25 and 40 sec. Tumor-to-liver contrast was significantly greater in group A than group B during the late arterial phase (40 sec, p = 0.02), although there was no significant difference at 25, 60, and 180 sec. Contrast materials with higher iodine concentration are more effective for depicting hypervascular HCCs on MDCT during the late arterial phase.