Are Unenhanced Scans Necessary in Biphasic Contrast-enhanced Helical CT for Detection of Hepatic Tumors?

本文針對228名已知或疑有肝臟腫瘤的患者進行肝臟的雙相對比增強螺旋CT檢查，探討在注射造影劑之前先獲取無對比增強影像的必要性。在223名列入分析的患者中，總共發現293處肝臟腫瘤，其中有2腫瘤(0.68%)在無對比增強影像中呈現低密度，而在注射造影劑後的影像中呈現和肝臟組織完全等密度。它們因此必須仰賴無對比增強影像才能偵查出來。就整體而言，在雙相對比增強螺旋CT檢查中，不論有或無使用對比增強影像，它們對偵查肝臟腫瘤的敏感度的差別，在統計學中並無意義，其重要性因而減少。必要時將它省略，應可節省檢查成本，提高CT掃描儀的使用率，並可減少對患者的曝照量。

關鍵字

腫瘤；肝臟；電腦斷層攝影；造影劑

並列摘要

We evaluated the need for preliminary unenhanced scans in biphasic contrast-enhanced helical CT for detection of hepatic tumors in 228 consecutive patients in this study. All patients had both unenhanced non-contrast (NC) and contrast-enhanced biphasic CT (BPCT) including hepatic arterial phase (HAP) and portal venous phase (PVP) studies with a helical CT scanner. Two hundred ninty-three hepatic tumors were found in 182 patients with the combined readings of NC, HAP and PVP images, but 2 (0.68%) were missed when the NC images were not included in the readings. There was no statistically significant difference in the sensitivities of lesion detection either with or without NC images when reading the BPCT (p＞ 0.99). As a consequence, the necessity of routine unenhanced CT prior to intravenous contrast enhancement is minimized when the clinical questions is the presence or absence of hepatic tumors. The elimination of unenhanced scans from helical BPCT of the liver could help in saving money, increasing patient throughput and reducing patient exposure to radiation.

並列關鍵字