TRIPHASIC SPIRAL CT SCANNING IN THE DIAGN OSIS OF LIVER-DISEASES - COMPARISON WITH CT ARTERIOGRAPHY AND CT ARTERIOPORTOGRAPHY

Purpose: Assessment of the diagnostic efficacy of triphasic spiral-CT scanning (TPS-CT) for liver disease evaluation. CT arteriography (CTA) and CT arterioportography (CTAP) were used as reference, methods whic h together have the highest sensitivity for detecting tumours and the perfusion conditions of the liver. Material and methods: 50 TPS-CT and CTA/CTPA were performed in 49 patients. After an initial examination without enhancement the first scan was initiated 15-25 s after the per ipheral bolus injection of contrast medium, the second after an inters can delay of 20-25 s. By this means the liver was imaged in different phases of perfusion. In the course of the CTA/CTPA-exam the imaging wa s carried out after selective, intraarterial application of contrast a gent. Results: The differentiation of the perfusion phases succeeded i n 90% of the patients. When compared with standard CT, which images on ly the portal venous phase, the new technique, which additionally show s the arterial perfusion, accomplished an increase in sensitivity for hypervascular lesions (51 % vs. 60 %). Yet in comparison with CTA/CTPA fewer lesions could be detected (87 vs. 138). Furthermore, by documen ting the contrast agent kinetics, characterisation of the lesion was a lso facilitated. Conclusion: DPS-CT is a valuable additional tool for imaging the liver, even if the information yield is less when compared to CTA/CTPA.