Document Detail


Contrast-enhanced CT of intrahepatic and hilar cholangiocarcinoma: delay time for optimal imaging.
MedLine Citation:
PMID:  9393152     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine the optimal time for obtaining delayed images with contrast-enhanced CT in patients who have intrahepatic or hilar cholangiocarcinoma. SUBJECTS AND METHODS: CT studies were performed in 25 consecutive patients with proven cholangiocarcinoma, including six patients who had undergone radiotherapy or chemotherapy. Dynamic images of the liver were obtained after 150 ml of IV contrast material was administered at 3 ml/sec. Delayed CT images were then obtained at 10, 20, and 30 min. Tumor-liver attenuation difference was determined quantitatively for each time period. Images were qualitatively evaluated by three observers for attenuation of the tumor (hypoattenuating, isoattenuating, or hyperattenuating) relative to the liver. Observer confidence for tumor detection was graded on a four-point scale. Dynamic and delayed images were compared for tumor conspicuity. RESULTS: On dynamic images, 18 tumors (72%) were hypoattenuating, six (24%) were isoattenuating, and one was heterogeneous. On delayed images, 15 (60%) of these 25 tumors were isoattenuating and nine (36%) were hyperattenuating compared with the liver. Tumor-liver attenuation difference was greatest on dynamic studies (p < .01) and did not differ significantly among the three delay times (p > .20). All tumors seen on delayed images were also seen on dynamic images; however, in three patients (12%), the confidence level for presence of tumor was better on delayed than on dynamic images. Confidence levels for presence of tumor did not vary significantly among the three delay times. Attenuation values on dynamic and delayed images did not differ for the groups of patients who had or had not undergone prior radiotherapy or chemotherapy (p > .05). CONCLUSION: In the evaluation of hilar or intrahepatic cholangiocarcinoma, delayed CT images are helpful for tumor characterization and may improve observer confidence for the presence of tumor. The optimal time for acquisition of delayed images is 10-20 min after contrast media injection.
Authors:
M T Keogan; J T Seabourn; E K Paulson; V G McDermott; D M Delong; R C Nelson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  169     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-01-02     Completed Date:  1998-01-02     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1493-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Bile Duct Neoplasms / radiography*
Bile Ducts, Intrahepatic / radiography*
Cholangiocarcinoma / radiography*
Contrast Media
Female
Humans
Iopamidol / diagnostic use
Liver / radiography
Male
Middle Aged
Prospective Studies
Time Factors
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 62883-00-5/Iopamidol

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