Patients
98 patients who were suspected to have hepatic metastasis,
underwent whole upper abdominal CTP examination.
Written informed consent obtained in all pts.
This study was limited to assessment of normal subjects proved by at least 6-months follow-up period,
because hemodynamics in patients with tumors or chronic diseases are quite different.
Therefore,
3 pts with hepatic metastasis,
2 with hepatic hemangioma,
1 with cirrhosis,
and 2 with chronic hepatitis were excluded.
Finally,
90 pts (m:57,
f: 33,
mean: 69.1 yrs) were included in this study.
Imaging Techniques
A 320 detector-row CT (Aquilion ONE,
Toshiba Medical Systems,
max.
cranio-caudal coverage:16cm)
Dynamic scans were conducted 7 to 120 secs after injection of CM under breathholdings.
The center of the scan volume was set at hepatic hilum.
Scanning conditions: 80kV,
210mA
Reconstruction: 0.5 mm thk x 320 slices
Injection dose and rate of CM: 30ml,
5ml/sec
Saline chaser: 25ml,
5ml/sec
Pre- and post-contrast abdomino-pelvic scans were also acquired with additional contrast medium injection of 70ml.
CM Administration Techniques
The patients were randomly divided into three groups; group 1 (370 mgI/ml),
group 2 (320 mgI/ml),
and group 3 (300 mgI/ml).
Demographic features of the groups were recorded and compared.
There was no significant difference in demographic features among the groups (Fig.
1).
Perfusion Analysis
Prototype workstation and software (Toshiba Medical Systems)
Respiratory misregistrations were corrected on the software.
The analytic methods Below were used.
- dual-input maximum slope (dMS)
- dual-input deconvolution (dDC)
- dual-input compartment model (dCM)
- single-input maximum slope (sMS)
- single-input deconvolution (sDC)
- single-input compartment model (sCM)
Perfusion values were measured in the normal parenchyma of the organs and were compared among the groups.
Estimated perfusion parameters
Liver
Hepatic arterial perfusion (HAP,
ml/min/100ml)(dMS,
dDC,
dCM)
Hepatic portal perfusion (HPP,
ml/min/100ml)(dMS,
dDC,
dCM)
Arterial perfusion fraction (APF,
%)(dMS,
dDC,
dCM)
Mean transit time (MTT,
sec)(dDC,
dCM)
Distribution volume (DV,
ml/min/100ml)(dDC,
dCM)
Spleen,
pancreas,
gastric wall
Arterial perfusion (AP,
ml/min/100ml)(sMS,
sDC,
sCM)
Mean transit time (MTT,
sec)(sDC,
sCM)
Distribution volume (DV,
ml/min/100ml)(sDC,
sCM)