Study Of Vascular Reconstruction In The Hepatocellular Carcinoma Using 16-slice Spiral CT

ObjectiveTo discuss the way of Multi-slice spiral CT angiography in the hepatocellular carcinoma, and to evaluate the clinical usefulness of a saline flush technique in improving the imaging quality of vascular reconstruction, and to study the clinical value of angiography of the hepatocellular carcinoma using 16-slice spiral CT.Material and methods180 cases(112 males and 68 females;age range 33-76 years old,mean age 52.8 years old) with hepatocellular carcinoma confirmed by clinical and medical imaging examination had been studid in this research since December, 2005 to December,2007.All patients were randomly divided into 3 groups(60 cases each group),the doles of the contrast in group A is 1.0ml/kg and group B is 1.5ml/kg.In group C,0.5ml/kg saline was injected in the same rate after injecting l.0ml/kg contrast.All the patients had to be fating 6 hours before examination and drink oral negative contrast(warm water) about 800-1000ml fifteen minutes before scanning. All the CTA were scanned and reconstructed by 16-slice spiral CT machine made by SIEMENS company. The scanning range was from the top of right diaphragm to the lower pole of kidneys. The contrast(Ultavest 300mgI/ml) was administrated from forearm veins by high pressure injector with velocity 3.5ml/s. The delay time on arterial stage were determined by the bolus tracking technique which threshold of touching off was 100Hu and the delay time on portal stage were 23 seconds after. Maximum intensity projection (MIP),Volume rendering technique (VRT) were used to reconstruct the liver vessels. All the hepatic CTA images were carefully observed by two experienced radiologists. According to the degrees of their visualization ,all the hepatic branches shown on the CTA images were endowed with different points to assess the value of different methods in hepatic vascular reconstruction.ResultsIn all reconstructed images, the abdominal aorta,the lelial artery,proper hepatic artery and the superior mesenteric artery were shown. The proportion of excellent or good images of hepatic artery were 50% in group A,50% in group B and 56.7% in group C, the difference in the three groups was not statistically significant(P=0.91).The proportion of excellent or good images of portal were 33.4% in group A,53.3% in group B and 58.4% in group C, the difference between group A and group B and the difference between group A and group C were statistically significant(P^* =0.013, P^** =0.020);the difference between group B and group C was not statistically significant(P=0.735).ConclusionMulti -slice spiral CT angiography is a non-invasive,safe and convenient technique for observing hepatic arteries,portal vein systems and hepatic tumorous vascular .The same quality images of reconstruction can be made with lower doles contrast by using saline flush. The hepatic vascular reconstruction with MIP and VRT technique is useful to evaluate hepatic vessels for surgical operation or interventional therapy.