PURPOSE: To determine the value of a rapid acquisition triple pass hepatic CT technique using a multislice (four slice)helical CT scanner - GE CT QXi in cirrhotic and noncirrhotic patients assessed for hypervascular primary and metastatic neoplasm.
METHOD AND MATERIALS: Twenty cirrhotic (CP) and 20 noncirrhotic (NCP) patients underwent triple pass hepatic CT (first pass (aortic peak - 10 seconds), second pass (aortic peak +15-25 seconds), third pass (60-70 seconds post injection)) following bolus IV contrast injection (4-5 cc/sec - 30 seconds). Hepatic mesenteric CT arteriography was routinely obtained from first pass data. Separation of the true hepatic arterial (first)phase from the portal venous - late arterial (second) phase and hepatic venous phase was determined by serial measurements of arterial, portal vein and hepatic enhancement. Tumor/liver contrast (TLC) in 19 patients with hepatoma (CP) and 10 patients with hypervascular metastases (NCP) was determined in each sequential phase. Enhancement differences between phases in cirrhotic and noncirrhotic patients and TLC in each phase was assessed by standard T-test.
RESULTS: Rapid pass technique separated each circulation phase in CP and NCP (P< 0.05). All normal and aberrant hepatic artery branches were portrayed in CT arteriograms (pretransplant, preresection patients.) In both CP and NCP, maximum TLC occurred in the late arterial/portal venous inflow phase (P< 0.05).
CONCLUSIONS: Rapid triple pass hepatic CT separates a true arterial phase from portal venous inflow phase and later hepatic phase in both CP and NCP. First pass provides optimum data for hepatic CT arteriography and second pass for hypervascular tumor detection. (WDF has an Investigator Agreement, General Electric Medical Systems CT Division).
