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Techniques for computed tomography of the liver.
1Department of Radiology, Emory University School of Medicine, Atlanta, Georgia.
Radiologic Clinics of North America
|November 1, 1991
Summary
For liver screening, dynamic CT with ample contrast is recommended. Delayed CT or CT arteriography/portography (CTAP) may be needed for specific liver lesions or suspected tumors.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Liver neoplasia requires accurate detection.
- Optimal imaging techniques are crucial for diagnosing liver lesions.
Purpose of the Study:
- To recommend optimal CT techniques for liver screening and lesion detection.
- To evaluate the utility of various CT protocols, including dynamic, delayed, and CT arteriography/portography (CTAP).
Main Methods:
- Dynamic CT with a 150 mL bolus of 60% iodinated contrast and 7 sections/minute.
- Delayed CT (4-6 hours) after 60g iodine for specific cases.
- CT arteriography/portography (CTAP) for pre-resection evaluation.
- Combination of CTAP and MRI for enhanced lesion detection.
Main Results:
- Dynamic CT is recommended for routine liver screening, especially for neoplasia.
- Noncontrast CT is generally not indicated unless hypervascular tumors are suspected.
- Delayed CT improves lesion-to-liver contrast and is useful for indeterminate lesions or perfusion defects.
- CTAP offers high sensitivity for focal hepatic lesions, particularly small ones.
- CT-Lipiodol is effective for detecting and palliating hepatocellular carcinomas.
Conclusions:
- Dynamic CT with sufficient contrast is the preferred method for routine liver screening.
- Delayed CT and CTAP are valuable adjuncts for specific diagnostic challenges and pre-surgical planning.
- Combining CTAP with MRI further enhances lesion detection rates.