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Depiction of hypervascular hepatocellular carcinoma with 64-MDCT : comparison of moderate- and high-concentration contrast material with and without saline flush . OBJECTIVE The purpose of this study was to evaluate prospectively the depiction of hypervascular hepatocellular carcinoma on 64-MDCT scans obtained with contrast agents of varying iodine concentrations administered with and without saline flush . SUBJECTS AND METHODS The study included 149 patients , among whom 36 patients with hypervascular hepatocellular carcinoma were identified . Patients were randomly assigned to one of three protocols : A , contrast material of 300 mg I/mL ; B , 370 mg I/mL ; C , 370 mg I/mL plus saline flush . In all protocols , the same iodine load per kilogram of body weight ( 516 mg/kg ) was administered for the same injection duration ( 30 seconds ) . Enhancement values in the aorta , liver , and portal vein and tumor-liver contrast were measured at multiphase CT . RESULTS Aortic enhancement was significantly different between protocols A and B ( p = 0.04 , p < 0.0001 ) and protocols B and C ( p = 0.02 , p < 0.001 ) in the first and second phases . Portal venous enhancement was significantly different between protocols B and C ( p = 0.02 ) in the first phase and between protocols B and C and protocols A and C ( p < 0.01 , p = 0.02 ) in the second phase . Tumor-liver contrast was significantly different between protocols A and B ( p = 0.03 , p = 0.02 ) and protocols B and C ( p = 0.03 , p = 0.04 ) in the first and second phases but not between protocols A and C. There was no significant difference in hepatic enhancement among the three protocols . CONCLUSION Use of moderate concentration was more effective than use of a high concentration of contrast material for depiction of hepatocellular carcinoma . Adding a saline flush to the high-concentration protocol eliminated the difference in depiction of hepatocellular carcinoma between the moderate- and high-concentration protocols .
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Intervention_Physical
moderate- and high-concentration contrast material with and without saline flush
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Intervention_Pharmacological
contrast agents
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Intervention_Pharmacological
iodine concentrations
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Intervention_Pharmacological
saline flush
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Intervention_Pharmacological
contrast material of 300 mg I/mL ; B , 370 mg I/mL ; C , 370 mg I/mL plus saline flush
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Intervention_Physical
same iodine load per kilogram of body weight
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Intervention_Pharmacological
high-concentration protocol
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Outcome_Physical
Depiction of hypervascular hepatocellular carcinoma
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Outcome_Physical
depiction of hypervascular hepatocellular carcinoma
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Outcome_Physical
Enhancement values in the aorta , liver , and portal vein and tumor-liver contrast
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Outcome_Physical
Aortic enhancement
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Outcome_Physical
Portal venous enhancement
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Outcome_Other
Tumor-liver contrast
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Outcome_Physical
hepatic enhancement
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Outcome_Physical
depiction of hepatocellular carcinoma
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Participant_Condition
hypervascular hepatocellular carcinoma
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Participant_Sample-size
149 patients
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Participant_Sample-size
36 patients
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Participant_Condition
hypervascular hepatocellular carcinoma