Nodular Hepatocellular Carcinoma: Enhancing Patterns in the Arterial- and Portal-dominant Phases of Spiral CT

Seo, Joon Beom; Choi, Byung Ihn; Han, Joon Koo; Lee, Hak Jong; Chung, Jin Wook; Park, Jae Hyung

Abstract

PURPOSE
To evaluate the enhancing patterns of nodular hepatocellular carcinomas (HCCs) in the arterial-andportal-dominant phases of spiral CT.
MATERIALS AND METHODS
A retrospective analysis of enhancing patterns was performed in 100 patients with HCCs diagnosed by pathologic findings (n=30) or clinical and radiological findings. CT images were obtained 30 seconds(arterial-dominant phase) and 65 seconds(portal-dominant phase) after beginning injection of contrast medium (120mL, 3mL/sec). After transarterial chemoembolization, 179 tumors detected oniodized oil-CT were divided into four groups according to their largest diameter, as follows ; group I(smallerthan 1cm, n=51), II(1-2cm, n=46), III(2-3cm, n=32), IV(larger than 3cm, n=50). The enhancing patterns of tumorscompared with attenuation of surrounding liver parenchyma, were divided into four types, namely high, iso, low andmixed.
RESULTS
Each group showed a different enhancing pattern ; group I showed iso-attenuation in both arterial- and portal-dominant phases (n=41, 80% and n=50, 98%), group II showed high-attenuation in the arterial-dominant phase (n=38, 83%) and iso-attenuation in the portal-dominant phase(n=34, 74%), group III showed high-attenuation in the arterial-dominant phase(n=19, 59%) and low-attenuation in the portal-dominant phase(n=17,53%), and group IV showed mixed-attenuation in both arterial- and portal-dominant phases(n=30, 60% and n=26, 52%).
CONCLUSION
Hepatocellular carcinomas showed variable enhancing patterns on two-phase spiral CT according to thesize of tumors, and this reflected their hemodynamic characteristics.