[Clinical application of 320-row computed tomography 4D digital subtraction angiography in hepatocellular carcinoma]
Jin Wang1, Bi-hong Liao1, Jing-jing Liu1
1Departments of Radiology, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
Insights
320-row CT 4D DSA accurately visualizes hepatic artery anatomy and HCC tumor vascularity. This noninvasive technique offers a rapid, DSA-like alternative for evaluating liver cancer blood supply.
Area of Science:
- Radiology
- Vascular Imaging
- Hepatobiliary Imaging
Background:
- Hepatocellular carcinoma (HCC) diagnosis and treatment planning require detailed vascular assessment.
- Conventional digital subtraction angiography (DSA) is invasive and carries risks.
- There is a need for noninvasive imaging modalities to evaluate hepatic artery anatomy and tumor vascularity in HCC.
Purpose of the Study:
- To evaluate the clinical application value of 320-row computed tomography (CT) 4D digital subtraction angiography (DSA) in patients with hepatocellular carcinoma (HCC).
Main Methods:
- 40 HCC patients underwent 320-row CT contrast scans to acquire 4D DSA images.
- Hepatic artery anatomy, variations, tumor-supplying arteries, tumor vessels, and tumor staining were assessed.
- Image findings were compared with conventional DSA in a subset of patients (n=20).
Main Results:
- 320-row CT 4D DSA visualized 6-7 levels of intrahepatic arterial branches.
- It accurately depicted normal hepatic artery anatomy (87.5%) and variations (12.5%) with 100% accordance to DSA.
- The modality showed tumor staining (100%), tumor vessels (70%), and tumor-supplying arteries (65%), achieving a 94.7% accuracy rate for detecting tumor-supplying arteries compared to DSA.
Conclusions:
- 320-row CT 4D DSA is a noninvasive modality that accurately visualizes hepatic artery anatomy and variations.
- It dynamically displays tumor staining and delineates the 3D relationship between HCC and blood vessels.
- This technique offers a rapid, DSA-like, and noninvasive alternative for assessing HCC vascularity.
Objective:
To explore the application value of 320-row computed tomography (CT) 4D digital subtraction angiography (DSA) for hepatocellular carcinoma (HCC).
Methods:
A total of 40 HCC patients received 320-row CT contrast scans. The 4D DSA images were obtained on the basis of baseline data. The normal anatomy and anatomical variations of hepatic artery, tumor supplying arteries, tumor vessels, tumor staining were observed by comparing DSA (n = 20).
Results:
320-row CT 4D DSA could show 6-7 levels of intrahepatic arterial branch. Normal hepatic artery anatomy was found in 35 cases (87.5%, Michels I type) and variations in 5 cases (12.5%). The diagnose accordance rate was 100% between 4D DSA and DSA in showing the anatomy and variation of hepatic artery. Among them, 320-row CT 4D DSA showed tumor staining (n = 40), tumor vessels (n = 28), tumor supplying arteries (n = 26) and two hepatic supplying arteries (n = 3). The number of tumor supplying arteries observed by 4D DSA (n = 20) was 18 versus 19 by DSA. Compared with DSA, the accurate rate of 4D DSA was 94.7% (18/19) in detecting tumor supplying arteries.
Conclusion:
As a noninvasive vascular examination modality, 320-row CT 4D DSA can accurately visualize normal anatomy and variation of hepatic artery, dynamically display tumor staining and reproducibly delineate the three-dimension relationship between tumor and blood vessels. In consistency with DSA in detection blood supply of HCC, 320-row CT 4D DSA provides a rapid, DSA-like and non-invasive alternative.
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