SPIRAL CT FOR THE DETECTION OF HEPATOCELLULAR CARCINOMAS - RELATIVE VALUE OF ARTERIAL-PHASE AND LATE-PHASE SCANNING

Background: Spiral computed tomography (CT) can image the Liver during arterial and late phases of contrast and optimize the evaluation of h ypervascular tumor. The objective of this study was to evaluate the re lative value of arterial- and late-phase spiral CT in the detection of hepatocellular carcinomas. Methods: Fifty-eight patients with hepatoc ellular carcinomas underwent two-phase spiral CT examination with IO-m m collimation at 10 mm/s table speed (Siemens Somatom Plus S), and 120 mt of contrast material (36 g iodine) was injected at the rate of 3 m L/s. CT images of hepatic arterial and late phases were obtained with a 35-s and 180-s delay, respectively. Results: In 58 patients, 111 hep atocellular carcinoma lesions were seen. The arterial phase detected 9 3 (84%) and the late phase 75 (68%) lesions (p < 0.01). The arterial p hase detected more lesions in 11 patients, and the late phase dected m ore in two patients and an equal number in 45 patients. Iflesions larg er than 2 cm are excluded, the arterial phase detected 40 (74%) and th e late phase 21 (39%) of 54 lesions (p < 0.001). Conclusion: The arter ial phase of spiral CT greatly improves the detection of hepatocellula r carcinoma when compared with the late phase.