Liver Cancer
Copyright ©2005 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 14, 2005; 11(2): 200-203
Published online Jan 14, 2005. doi: 10.3748/wjg.v11.i2.200
Detection of hypervascular hepatocellular carcinoma: Comparison of multi-detector CT with digital subtraction angiography and Lipiodol CT
Xiao-Hua Zheng, Yong-Song Guan, Xiang-Ping Zhou, Juan Huang, Long Sun, Xiao Li, Yuan Liu
Xiao-Hua Zheng, Yong-Song Guan, Xiang-Ping Zhou, Juan Huang, Long Sun, Xiao Li, Yuan Liu, Department of Radiology, Huaxi Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: All authors contributed equally to the work.
Supported by the Medical Science Research Fund of Sichuan Province, No. 200054
Correspondence to: Dr. Yong-Song Guan, Department of Radiology, Huaxi Hospital, Sichuan University, 37 Guoxuexiang, Chengdu 610041, Sichuan Province, China. yongsongguan@yahoo.com
Telephone: +86-28-85421008 Fax: +86-28-85421008
Received: April 19, 2004
Revised: April 21, 2004
Accepted: May 9, 2004
Published online: January 14, 2005
Abstract

AIM: The purpose of this study was to compare the diagnostic accuracy of biphasic multi-detector row helical computed tomography (MDCT), digital subtraction angiography (DSA) and Lipiodol computed tomography (CT) in detection of hypervascular hepatocellular carcinoma (HCC).

METHODS: Twenty-eight patients with nodular HCC underwent biphasic MDCT examination: hepatic arterial phase (HAP) 25 s and portal venous phase (PVP) 70 s after injection of the contrast medium (1.5 mL/kg). They also underwent hepatic angiography and intra-arterial infusion of iodized oil. Lipiodol CT was performed 3-4 wk after infusion. MDCT images were compared with DSA and Lipiodol CT images for detection of hepatic nodules.

RESULTS: The three imaging techniques had the same sensitivity in detecting nodules >20 mm in diameter. There was no significant difference in the sensitivity among HAP-MDCT, Lipiodol CT and DSA for nodules of 10-20 mm in diameter. For the nodules <10 mm in diameter, HAP-MDCT identified 47, Lipiodol CT detected 27 (χ2 = 11.3, P = 0.005<0.01, HAP-MDCT vs Lipiodol CT) and DSA detected 16 (χ2 = 9.09, P = 0.005<0.01 vs Lipiodol CT and χ2 = 29.03, P = 0.005<0.01vs HAP-MDCT). However, six nodules <10 mm in diameter were detected only by Lipiodol CT.

CONCLUSION: MDCT and Lipiodol CT are two complementary modalities. At present, MDCT does not obviate the need for DSA and subsequent Lipiodol CT as a preoperative examination for HCC.

Keywords: Hypervascular hepatocellular carcinoma; Multi-detector CT; Digital subtraction angiography; Lipiodol CT