Dynamic CT of hepatic masses with intravenous and intraarterial contrast material

Seven patients with primary and metastatic hepatic tumors had dynamic computed tomographic scans obtained after an intravenous and an intrahepatic arterial bolus of contrast media. Four patients had hepatoma and three had hepatic metastasis from either a colonic, pancreatic, or leiomyosarcoma primary malignancy. Computed tomography was also performed after an intravenous drip infusion of contrast material. Time-density curves of the hepatic lesions after contrast administration were analyzed and compared. The results demonstrated that: (1) intrahepatic arterial delivery of contrast fluid resulted in the greatest contrast enhancement of lesions and detected more lesions than the intravenous bolus technique, which was superior to the drip infusion technique; (2) no consistent difference in the pattern of contrast enhancement was found between various hepatic lesions; (3) within multiple lesions of similar pathology in any one liver, a spectrum of contrast enhancement pattern was found; and (4) changes in contrast enhancement occurred rapidly and lesions changed from hypodense to isodense to hyperdense to isodense within 30--45 sec.