Small hepatocellular carcinomas: two-phase dynamic incremental CT in detection and evaluation.

Abstract

To compare dynamic incremental computed tomography (CT) with other techniques in detecting and evaluating small hepatocellular carcinomas (HCCs). Two-phase (early vascular and parenchymal) dynamic incremental CT of the entire liver and ultrasonography (US) were performed in 184 patients with chronic liver disease. Thirty patients had 36 small HCCs (less than 30 mm in diameter); 27 of these 30 patients also underwent CT after intraarterial injection of iodized oil, and the results were compared. The HCC detection rate was 92% with dynamic incremental CT, 69% with US, and 81% with iodized oil-enhanced CT. Of six well-differentiated HCCs, two were detected with the first dynamic incremental CT series and two with iodized oil-enhanced CT, whereas all were detected with the second dynamic incremental CT series and five with US. Two-phase dynamic incremental CT was superior to the other techniques and is a useful and easy procedure for routine follow-up of patients with chronic liver disease.