Multislice Dynamic Computed Tomography of the Liver Masses

ABSTRACTMultidetector Dynamic Computed Tomography of the Liver MassesM. Suat DURAKOĞLUGİLResidency Thesis, Department of RadiodiagnosticSupervisor: Assistant Prof. Dr. Reşat KERVANCIOĞLUFebruary 2008, 117 pagesIn department of radiodiagnostic, having focal liver mass or, known malignite with hepatic metastases, after making multidetector dynamic computed tomography (MDCT) without contrast, and then four-phase dynamic study (early and late arterial, portal and delayed phase) had done. In the cases that have hemangioma, in 10. and 20. minutes and added more slices. In every phase of contrast enhancement patterns of the lesions (hypodense, hyperdense, isodense) and the quantitie of contrast (minimum, minimum-middle, middle, middle-maximum, maximum) appreciation and statistical analysis had done.20 of the 127 case (%15.7) was hemangioma, 16 was HCC (13 hypervascular,3 hypovascular), 82 was (%64.5) metastasis (77 hypovascular, 5 hypervascular), 3 was regeneration nodules, 3 was simple cyst , 2 was (%1.6) pseudo lesion and 1 was (%0.8) hamartoma. In 20 case 31 hemangioma was all hypodense without contrast material study, in early arterial phase %70.9 (minimum and middle), in late arterial and portal phase %100 (maximum) peripheral nodules hyperdense and in delayed phase hyper or isodens (minimal and middle-maximum degree). In 16 cases having HCC 2 of then was isodens in early arterial phase, 13 of the hypodense, 1 was hyperdense;in late arterial phase 3 was hypodense, 13 was hyperdense; in portal phase 8 was hypodense, 8 was hyperdense and in delayed phase 14 was hypodense, 2 was isodense.11 of 13 the hypervascular HCC had contrast in early arterial minimal and minimal-middle, 12 was in late arterial phase maximum, 8 was in portal phase maximum and 12 was in delayed phase minimal-middle. We find the best contrast range in late arterial (%92.3) and in the double phase study which consist of late arterial and portal phase (%100). With the case which is HCC, in 8 lesion venous enchance, in 6 lesion invasion out of capsul and in 6 of then capsular enchancement was found. %96.1 of the 77 hypovascular metastasis enchance hypodense in early arterial phase, %98.7 in late arterial, %100 portal phase and %98.7 delayed phase; in early arterial phase %100 minimal enchance degree was in late arterial %72.7 minimal-middle, in portal phase %92.2 middle and delayed phase %84.4 minimal-middle.Dynamic MDCT is a choise of diagnostic method in finding liver masses, finding out localizations, charecterization and planning treatment and imaging of hepatic perfusion failure. Triple phase dynamic study with late arterial phase can be enough. For the hemangioma late added slices such as 10. and 20. minutes can be necessary.Key Words: Focal liver masses, Multi-Detector CT