LIVER ANGIO-CT IN NORMAL SUBJECTS AND IN PATIENTS WITH HEPATIC-TUMORS - HEMODYNAMIC AND MORPHOLOGICAL-CHARACTERISTICS

Abstract

Hepatic angio-CT [computed tomography] was performed according to a standardized schedule in 100 healthy subjects and 260 patients with a liver tumor. In normal subjects, it was possible to determine an arterial phase (15 s), a parenchymatous arterial phase (30 s), a parenchymatous portal phase (45 s) followed by a progressive return to liver densities observed before injection. Among the 62 cases of hepatocellular carcinoma, 56 were characterized by hypodensity, 3 cases by hyperdensity and 3 cases by isodensity before injection. After injection, slices obtained at the tumor level showed heterogeneous hypervascularization in 34 cases, and an early homogeneous hypervascularization (15th-30th s) in 7 small carcinomas (diameter < 3 cm); a lesion was disclosed in the other hepatic lobe in 12 cases. Slices obtained at the level of the portal vein allowed the assessing of tumoral involvement in 6.0 of the cases. Out of 150 cases of hepatic metastases, a hypodense lesion surrounded by hypervascularization just after injection was the most frequent aspect. Out of 40 cases of hemangiomas, lesions were hypodense and well limited in 37 cases; at the 15th s after injection, contrast medium accumulated at the periphery, then diffused to the center of the lesion. Adenomas and focal nodular hyperplasias appeared as hypodense lesions with precocious and fugacious hypervascularization, and were characterized, although inconstantly, by the presence of fat and vessels in the hypodense central zone, respectively. A rational basis for a better diagnostic approach of liver tumors.