Multidetector CT (64 Slices) of the liver: examination techniques

Andrea Laghi1,2
1Department of Radiological Sciences, University of Rome “La Sapienza”, Latina, Italy
2Rome, Italy

Tóm tắt

Sixty-four-row MDCT, although developed primarily for cardiac imaging, has the potential to have a great impact on liver imaging as well. Liver-imaging protocols with sub-millimeter collimation improve longitudinal spatial resolution, making the acquired dataset a real isotropic volume perfectly designed for optimal three-dimensional rendering and accurate organ and lesion volumetry. The 64-row detector array offers a wide volumetric coverage (up to 40 mm), suitable not only for shortening scanning time and improving spatial resolution, but also for including a large volume per single rotation, particularly useful for accurate CT perfusion studies. In order to take full benefit from the enormous performance offered by new 64-row MDCT scanners, imaging protocols need to be redesigned. Due to the extremely short scanning window, contrast agent injection should be performed at high flow rate and followed by saline bolus chaser; the use of highly concentrated contrast media might be useful. Timing should be accurately calculated either by a test bolus or, better, by using an automatic bolus-detection technique. Radiation exposure is kept under control, using automatic device-modulating dose delivery according to the patient’s anatomy. Finally, the evaluation of acquired volumetric datasets needs the extensive use of a dedicated workstation, with software with sophisticated rendering capabilities.

Từ khóa


Tài liệu tham khảo

Prokop M (2003) Multislice CT: technical principles and future trends. Eur Radiol 13(Suppl 5):M3–M13 Klingenbeck-Regn K, Schaller S, Flohr T et al (1999) Subsecond multi-slice computed tomography: basics and applications. Eur J Radiol 31:110–124 Hu H, He HD, Foley WD, Fox SH (2000) Four multidetector-row helical CT: image quality and volume coverage speed. Radiology 215:55–62 Prokop (2003) Image processing and display techniques. In: Prokop M, Galanski M (eds) Spiral and multislice computed tomography of the body. Thieme, Stuttgart, pp 131–160 Brink JA (2003) Contrast optimization and scan timing for single- and multidetector-row computed tomography. J Comput Assist Tomogr 27 Suppl 1:S3–8 Fleischmann D (2003) Future prospects in MDCT imaging. Eur Radiol 13(Suppl 5):M127–M128 Prokop M (2003) General principles of MDCT. Eur J Radiol 45:S4–S10 Flohr T, Stierstorfer K, Bruder H, Simon J, Schaller S (2002) New technical developments in multislice CT. Part 1: approaching isotropic resolution with sub-millimeter 16-slice scanning. RöFo Fortschr Röntgenstr 174:839–845 Oto A, Tamm EP, Szklaruk J (2005) Multidetector row CT of the liver. Radiol Clin N Am 43:827–848 Pandharipande PV, Krinsky GA, Rusinek H, Lee VS (2005) Perfusion imaging of the liver: current challenges and future goals. Radiology 234:661–673 Platten D, Keat N, Lewis M, Edyvean S (2005) Report 05068. 32 to 64 slice CT scanner comparison report version 13. ImPACT, Purchasing and Supply Agency 1–23 Flohr TG, Stierstorfer K, Ulzheimer S et al (2005) Image reconstruction and image quality evaluation for a 64-slice CT scanner with z-flying focal spot. Med Phys 32(8):2536–2547 Abdelmoumene A, Chevallier P, Chalaron M et al (2005) Detection of liver metastases under 2 cm: comparison of different acquisition protocols in four row multidetector-CT (MDCT). Eur Radiol 15(9):1881–1887 Fenchel S, Fleiter TR, Merkle EM (2002) Multislice helical CT of the abdomen. Eur Radiol 12 (Suppl 2):S5–S10 Mulkens TH, Bellinck P, Baeyaert M et al (2005) Use of an automatic exposure control mechanism for dose optimization in multi-detector row CT examinations: clinical evaluation. Radiology 237(1):213–223 Kalra MK, Maher MM, Toth TL et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233(3):649–657 Foley WD, Mallisee TA, Hohenwalter MD et al (2000) Multiphase hepatic CT with a multirow detector CT scanner. AJR Am J Roentgenol 175:679–685 Laghi A, Iannaccone R, Rossi P et al (2003) Hepatocellular carcinoma: detection with triple-phase multi-detector row CT in patients with chronic hepatitis. Radiology 226:543–549 Murakami T, Kim T, Takamura M et al (2001) Hypervascular hepatocellular carcinoma: detection with double arterial phase multi-detector row helical CT. Radiology 218:763–767 Itoh S, Ikeda M, Achiwa M, Satake H, Iwano S, Ishigaki T (2004) Late-arterial and portal-venous phase imaging of the liver with a multislice CT scanner in patients without circulatory disturbances: automatic bolus tracking or empirical scan delay? Eur Radiol 14(9):1665–1673 Fleischmann D (2003) Use of high-concentration contrast media in multiple-detector-row CT: principles and rationale. Eur Radiol 13:M14–M20 Kim T, Murakami T, Takahashi S et al (1998) Effects of injection rates of contrast material on arterial phase hepatic CT. AJR Am J Roentgenol 171(2):429–432 Awai K, Takada K, Onishi H et al (2002) Aortic and hepatic enhancement and tumor to liver contrast: analysis of the effect of different concentrations of contrast material at multi-detector row helical CT. Radiology 224:757–763 Marchianò A (2003) MDCT of Primary liver malignancies. Eur Radiol 13:M26–M30 Suzuki H, Oshima H, Shiraki N, Ikeya C, Shibamoto Y (2004) Comparison of two contrast materials with different iodine concentrations in enhancing the density of the the aorta, portal vein and liver at multi-detector row CT: a randomized study. Eur Radiol 14(11):2099–2104 Schoellnast H, Tillich M, Deutschmann HA et al (2004) Improvement of parenchymal and vascular enhancement using saline flush and power injection for multiple-detector-row abdominal CT. Eur Radiol 14(4):659–664 Dorio PJ, Lee FT Jr, Henseler KP et al (2003) Shock SA. Using a saline chaser to decrease contrast media in abdominal CT. AJR Am J Roentgenol 180:929–934 Rubin GD (2000) Data explosion: the challenge of multidetector-row CT. Eur J Radiol 36:74–80 Kamel IR, Georgiades C, Fishman EK (2003) Incremental value of advanced image processing of multislice computed tomography data in the evaluation of hypervascular liver lesions. J Comput Assist Tomogr 27:652–656 Raptopoulos V, Kataoka M, Siewert B, Goldberg SN; Sheiman R, Kruskal J. Clinically perceived value of routine coronal and sagittal multiplanar reconstructions in abdominal CT scans: increased value with increased detector-rows from 4- to 64-row MDCT. Radiology (p) 296 abstract Sahani D, Krishnamurthy S, Kalva S et al (2004) Multidetector-row computed tomography angiography for planning intra-arterial chemotherapy pump placement in patients with colorectal metastases to the liver. J Comput Assist Tomogr 28:478–484 Guiney MJ, Kruskal JB, Sosna J et al (2003) Multi-detector row CT of relevant vascular anatomy of the surgical plane in split-liver transplantation. Radiology 229:401–407 Schroeder T, Nadalin S, Stattaus J et al (2002) Potential living liver donors: evaluation with an all-in-one protocol with multi-detector row CT. Radiology 224:586–591 Becker CD (2003) Multidetector CT and MRI of biliary diseases. J Radiol 84:473–479 Abdalla EK, Denys A, Chevalier P, Nemr RA, Vauthey JN (2004) Total and segmental liver volume variations: implications for liver surgery. Surgery 135:404–410 Lang H, Radtke A, Hindennach M et al (2005) Impact of virtual tumor resection and computer-assisted risk analysis on operation planning and intraoperative strategy in major hepatic resection. Arch Surg 140(7):629–638 Meier S, Schenk A, Mildenberger P et al (2004) Evaluation of a new software tool for the automatic volume calculation of hepatic tumors. First results. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 176:234–238 Castillo OA, Keriakos K, Stinchon JF, Jara H, Soto JA (2005) Automated liver segmentation and volume calculation from MDCT data sets using a dual-clustering technique: comparison with planimetry. Radiology (p) 509 abstract Blomley MJK, Coulden R, Dawson P et al (1995) Liver perfusion studied with ultrafast CT. J Comput Assist Tomogr 19:424–433 Guan S, Zhao WD, Zhou KR, Peng WJ, Mao J, Tang F (2005) CT perfusion at early stage of hepatic diffuse disease. World J Gastroenterol 11(22):3465–3467 Nakashige A, Horiguchi J, Tamura A et al (2004) Quantitative measurement of hepatic portal perfusion by multidetector row CT with compensation for respiratory misregistration. Br J Radiol 77:728–734 Weidekamm C, Cejna M, Kramer L, Peck-Radosavljevic M, Bader TR (2005) Effects of TIPS on liver perfusion measured by dynamic CT. AJR Am J Roentgenol 184:505–510 Holalkere NS, Sahani DV, Zhu AX, Setty BN, Muller PR (2005) CT perfusion in patients with advanced hepatocellular carcinoma (HCC): an initial experience. Radiology (p) 327 Fabiano S, Squillaci E, Carlani M et al (2005) CT perfusion studies of liver lesions with a 64-detector row scanner: initial clinical results. Radiology (p) 837 abstract Tsushima Y, Funabasama S, Aoki J et al (2004) Quantitative perfusion map of malignant liver tumors, created for dynamic computed tomography data. Acad Radiol 11:215–222 abstract