Download PDF
Semin Liver Dis 2001; 21(2): 135-146
DOI: 10.1055/s-2001-15341
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

CT Evaluation of the Liver: Principles and Techniques

Michael P. Federle, Arye Blachar
  • Division of Abdominal Imaging, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Further Information

Publication History

Publication Date:
31 December 2001 (online)

    Permissions and Reprints

ABSTRACT

Technical advances within the past decade have dramatically improved the diagnostic capabilities of CT, primarily due to helical CT scanners coupled with mechanical injectors for IV administration of contrast media. There is no such thing as a generic ``abdominal CT scan''; rather, specific protocols should be utilized for optimal detection and characterization of hepatic masses (or other suspected pathologic processes). Multiphasic CT protocols are especially important for detecting hypervascular liver tumors. We present the principles and rationale for various CT protocols along with some of the common pitfalls. Understanding this background material will allow the reader to better understand subsequent articles dealing with specific applications of CT and other abdominal imaging techniques.

KEYWORD

Computed tomography - liver

REFERENCES

  • 1 Federle M P. Current status and future trends in abdominal CT.  RadioGraphics . 1998;  18 1555-1568
    PubMedGoogle Scholar
  • 2 Oliver J H, Baron R L, Federle M P, Rockette H P. Detecting hepatocellular carcinoma: value of unenhanced or arterial phase CT imaging or both in conjunction with conventional portal venous phase contrast CT imaging.  Am J Roentgenol . 1996;  167 71-77
    PubMedGoogle Scholar
  • 3 Baron R L, Oliver J H, Dodd G D. Hepatocellular carcinoma: evaluation with biphasic contrast-enhanced helical CT.  Radiology . 1996;  199 505-511
    PubMedGoogle Scholar
  • 4 Hollett M D, Jeffrey Jr B R, Nino-Murcia M. Dual-phase helical CT of the liver: value of arterial phase scans in the detection of small (≤1.5 cm) malignant hepatic neoplasms.  Am J Roentgenol . 1995;  164 879-884
    PubMedGoogle Scholar
  • 5 Bonaldi V M, Bret P M, Reinhold C, Atri M. Helical CT of the liver: value of an early hepatic arterial phase.  Radiology . 1995;  197 357-363
    CrossrefPubMedGoogle Scholar
  • 6 van Leeuwen S M, Noordzij J, Feldberg M A. Focal liver lesions: characterization with triphasic spiral CT.  Radiology . 1996;  201 327-336
    PubMedGoogle Scholar
  • 7 Weg N, Scheer M R, Gabor M P. Liver lesions: improved detection with dual-detector array CT and routine 2.5 mm thin collimation.  Radiology . 1998;  209 417-426
    PubMedGoogle Scholar
  • 8 Oliver J H, Baron R L. Helical biphasic contrast-enhanced CT of the liver: indications, interpretation, and pitfalls.  Radiology . 1996;  201 1-14
    PubMedGoogle Scholar
  • 9 Federle M P, Chang P J, Confer S, Ozgun B. Frequency and effects of extravasation of ionic and nonionic CT contrast media during rapid bolus injection.  Radiology . 1998;  206 637-640
    CrossrefPubMedGoogle Scholar
  • 10 Federle M P, Willis L L, Swanson D P. Ionic versus nonionic contrast media: a prospective study of the effect of rapid bolus injection on nausea and anaphylactoid reactions.  J Comput Assist Tomogr . 1998;  22 341-345
    CrossrefPubMedGoogle Scholar
  • 11 Bluemke D A, Soyer P, Fishman E K. Helical (spiral) CT of the liver.  Radiol Clin North Am . 1995;  33 863-886
    PubMedGoogle Scholar
  • 12 Baron R L. Understanding and optimizing use of contrast material for CT of the liver.  Am J Roentgenol . 1994;  163 323-331
    PubMedGoogle Scholar
  • 13 Peterson M S, Baron R L, Marsh J W. Pretransplantation surveillance for possible hepatocellular carcinoma in patients with cirrhosis epidemiology and CT-based tumor detection rate in 430 cases with surgical pathologic correlation.  Radiology . 2000;  217 743-749
    CrossrefPubMedGoogle Scholar
  • 14 Kim T, Murakami T, Takahashi S. Optimal phases of dynamic CT for detecting hepatocellular carcinoma: evaluation of unenhanced and triple phase images.  Abdom Imaging . 1999;  24 473-480
    CrossrefPubMedGoogle Scholar
  • 15 van Hoe L, Baert A L, Gryspeerdt S. Dual-phase helical CT of the liver: value of an early-phase acquisition in the differential diagnosis of noncystic focal lesions.  Am J Roentgenol . 1997;  168 1185-1192
    PubMedGoogle Scholar
  • 16 Matsui O, Takashima T, Kadoya M. Liver metastases from colorectal cancers: detection with CT during arterial portography.  Radiology . 1987;  165 65-69
    PubMedGoogle Scholar
  • 17 Soyer P, Levesgre M, Elias D. Detection of liver metastases from colorectal cancer: comparison of intraoperative US and CT during arterial portography.  Radiology . 1992;  183 541-544
    PubMedGoogle Scholar
  • 18 Soyer P, Bluemke D A, Hruban R H. Primary malignant tumors of the liver: detection with helical CT during arterial portography.  Radiology . 1994;  192 389-392
    PubMedGoogle Scholar
  • 19 Soyer P, Bluemke D A, Hruban R H. Hepatic metastases from colorectal cancer: detection and false-positive findings with helical CT during arterial portography.  Radiology . 1994;  193 71-74
    PubMedGoogle Scholar
  • 20 Kondo H, Kanamatsu M, Hoshi H. Preoperative detection of malignant hepatic tumors: comparison of combined methods of MR imaging with combined methods of CT.  Am J Roentgenol . 2000;  174 947-954
    PubMedGoogle Scholar
  • 21 Foley W D, Hoffmann R G, Quiroz F A. Hepatic helical CT: contrast material injection protocol.  Radiology . 1994;  192 367-371
    PubMedGoogle Scholar
  • 22 Silverman P M, Brown B, Wray H. Optimal contrast enhancement of the liver using helical (spiral) CT: value of Smart-Prep.  Am J Roentgenol . 1995;  164 1169-1171
    PubMedGoogle Scholar
  • 23 Lacomis J M, Baron R L, Oliver J H. Cholangiocarcinoma: delayed CT contrast enhancement patterns.  Radiology . 1997;  203 98-104
    PubMedGoogle Scholar
  • 24 Ueda K, Matui O, Kawamori Y. Hypervascular hepatocellular carcinoma: evaluation of hemodynamics with dynamic CT during hepatic arteriography.  Radiology . 1998;  206 161-166
    PubMedGoogle Scholar
  • 25 Murakami T, Oi H, Hori M. Helical CT during arterial portography and hepatic arteriography for detecting hypervascular hepatocellular carcinoma.  Am J Roentgenol . 1997;  169 131-135
    PubMedGoogle Scholar
  • 26 Choi B I, Lee H J, Han J K. Detection of hypervascular nodular hepatocellular carcinomas: value of triphasic helical CT compared with iodized-oil CT.  Am J Roentgenol . 1997;  168 219-224
    PubMedGoogle Scholar
  • 27 Katyal S, Oliver J H, Buck D G, Federle M P. Detection of vascular complications following liver transplantation: early experience of multi-slice CT angiography using volume-rendering techniques.  Am J Roentgenol . 2000;  175 1735-1739
    PubMedGoogle Scholar
  • 28 Kuszyk B S, Heath D G, Ney D R. CT angiography with volume rendering: imaging findings.  Am J Roentgenol . 1995;  165 445-448
    PubMedGoogle Scholar
      >