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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:1065-1069 • 0278-4297

Technical Advance

Hepatic Computed Tomography for Simultaneous Depiction of Hepatocellular Carcinoma, Intrahepatic Portal Veins, and Hepatic Veins in Real-time Virtual Sonography

Initial Experience

Fuminari Tatsugami, MD, Mitsuru Matsuki, MD, Go Nakai, MD, Masato Tanikake, MD, Shushi Yoshikawa, RT, Isamu Narabayashi, MD, Katsuhiko Miyaji, MD, Akira Asai, MD, Shinya Fujiwara, MD, Yasushi Hongo, MD and Kenichi Katsu, MD

Department of Radiology (F.T., M.M., G.N., M.T., S.Y., I.N.), Second Department of Internal Medicine (K.M., S.F., Y.H., K.K.), and First Department of Internal Medicine (A.A.), Osaka Medical College, Osaka, Japan.

Address correspondence to Fuminari Tatsugami, MD, Department of Radiology, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan. E-mail: sa104{at}rg8.so-net.ne.jp

Objective. The aim of this study was to examine a double-step injection of contrast material in hepatic computed tomography (CT) for the simultaneous depiction of hepatocellular carcinoma (HCC), intrahepatic portal veins, and hepatic veins in real-time virtual sonography. Methods. This study consisted of 6 patients with solitary HCC nodules with early enhancement on dynamic contrast-enhanced CT. Computed tomographic scanning was performed in a combined late arterial/hepatic phase after 2 sequential contrast material injections. Results. In all 6 patients, the solitary HCC nodule, intrahepatic portal veins, and hepatic veins were simultaneously visualized with enhancement, for which CT values were appreciably higher than that of the liver parenchyma. In virtual sonography, HCC nodules and intrahepatic vessels were simultaneously shown, and the HCC lesions were treated by radio frequency ablation without vascular injury. Conclusions. A double-step injection of contrast material in hepatic CT was helpful in the identification of the relationship between the HCC nodule and intrahepatic vessels under virtual sonography and contributed to the accurate and safe performance of radio frequency ablation for HCC.

Key Words: contrast material • hepatocellular carcinoma • multidetector computed tomography • radio frequency ablation • sonography

Abbreviations: CT, computed tomography • HCC, hepatocellular carcinoma • RFA, radio frequency ablation

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