Diagnostic accuracy of contrast-enhanced dynamic CT for small hypervascular hepatocellular carcinoma and assessment of dynamic enhancement patterns: Results of two-year follow-up using cone-beam CT hepatic arteriography.
Diagnostic accuracy of contrast-enhanced dynamic CT for small hypervascular hepatocellular carcinoma and assessment of dynamic enhancement patterns: Results of two-year follow-up using cone-beam CT hepatic arteriography.
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DOI：
10.1371/journal.pone.0203940
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Kim JH
中科院分区：
文献类型：
--
作者：
Choi YR;Chung JW;Yu MH;Lee M;Kim JH
目的评价CT对小而富血供肝细胞癌（HCC）诊断的准确性及增强模式。99例在CT上疑似HCC的初始化疗栓塞期间接受锥形束CT肝动脉造影（CBCT-HA）的患者入组本研究。根据2年随访CT和CBCT-HA图像，共297例多血管HCC（142例≥ 1 cm，155例< 1 cm）被确认为HCC。在2年随访期间，CBCT-HA上既存的富血管病灶在最初表现时被视为HCC。两名放射科医生根据CT上的以下增强模式对HCC进行分类：I型，动脉增强和洗脱; II型，动脉增强而无洗脱; III型，无动脉增强。两名设盲的审查员对HCC的可能性进行了评级。在297例HCC中，根据大小的增强模式如下：114例HCC中的I型≥1 cm; 40例HCC中的I型<1 cm; 16例HCC中的II型≥1 cm; 37例HCC中的II型<1 cm; 12例HCC中的III型≥1 cm; 10例HCC中的III型<1 cm。其余68例（22.9%）肝细胞癌CT未检出。评审员1和评审员2的正式报告中，≥ 1 cm HCC的检出率分别为83.1%、76.8%和83.1%。相比之下，审查员1和审查员2的正式报告中< 1 cm HCC的检出率分别为20.6%、17.4%和17.4%。许多亚厘米大小的富血供肝细胞癌在最初的诊断检查中经常被CT漏诊或不明显。CT对小于1cm或有不典型强化的HCC的诊断有局限性。
To evaluate the accuracy of CT for small, hypervascular hepatocellular carcinomas (HCCs) and assess the enhancement patterns on CT. Ninety-nine patients who underwent cone-beam CT hepatic arteriography (CBCT-HA) during initial chemoembolization for HCC suspected on CT were enrolled in this study. A total of 297 hypervascular HCCs (142 ≥ 1 cm, 155 < 1 cm) were confirmed as HCCs based on two-year follow-up CT and CBCT-HA images. During the two-year follow-up, pre-existing hypervascular foci on CBCT-HA were regarded as HCCs at the initial presentation. Two radiologists categorized HCCs according to the following enhancement patterns on CT: type I, arterial enhancement and washout; type II, arterial enhancement without washout; and type III, no arterial enhancement. Two blinded reviewers rated the possibility of HCC. For the 297 HCCs, the enhancement patterns according to size were as follows: type I ≥1 cm in 114 HCCs; type I <1 cm in 40 HCCs; type II ≥1 cm in 16 HCCs; type II <1 cm in 37 HCCs; type III ≥1 cm in 12 HCCs; and type III <1 cm in 10 HCCs. The remaining 68 HCCs (22.9%) were not detected on CT. The detection rates of HCCs ≥ 1 cm were 83.1%, 76.8%, and 83.1% in the formal report for reviewer 1 and reviewer 2. In comparison, the detection rates of HCCs < 1 cm were 20.6%, 17.4%, and 17.4% in the formal report for reviewer 1 and reviewer 2. Many subcentimeter sized hypervascular HCCs were frequently missed or not evident on CT at the initial diagnostic workup. CT has limitations for diagnosing HCCs that are <1 cm in size or have atypical enhancement patterns.
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影响因子：
2.6
作者：
Baek, C. -K.;Choi, J. -Y.;Kim, K. -W.
通讯作者：
Kim, K. -W.
影响因子：
5
作者：
Brancatelli, G;Baron, RL;Marsh, W
通讯作者：
Marsh, W
影响因子：
1.3
作者：
Rode, A;Bancel, B;Ducerf, C
通讯作者：
Ducerf, C
影响因子：
1.3
作者：
Kim, Young Kon;Kim, Chong Soo;Yu, Hee Chul
通讯作者：
Yu, Hee Chul
DOI：
10.1016/j.jvir.2014.04.011
发表时间：
2014-09-01
影响因子：
2.9
作者：
Lee, In Joon;Chung, Jin Wook;Park, Jae Hyung
通讯作者：
Park, Jae Hyung