Correlation of VEGF with contrast enhancement on dual-phase dynamic helical CT in liver tumors: preliminary study

The purpose of this preliminary study is to elucidate that vascular endothelial growth factor (VEGF) influences contrast enhancement of hepatic tumors on computed tomography (CT). Fourteen patients with hepatic tumors (11 hepatocellular carcinomas; 3 metastatic cancers) underwent a dual-phase dynamic helical CT or computed tomographic hepatic arteriography. The attenuation of each mass was determined as hyperattenuation, isoattenuation or hypoattenuation with respect to the adjacent nontumorous parenchyma. Gun-needle biopsy was done for each tumor, and paraffin sections were immunostained with anti- VEGF antibody by the avidin-biotin-peroxidase complex method. The pathologic grade was made by intensity (1 +, 2+, 3+) and area (+/-, 1 +, 2+). The tumor ranged 2.0-14.0 cm in size (mean, 5.8 cm). In arterial phase, the intensity was not correlated with the degree of enhancement (p=0.086). However, the correlation between the attenuation value of hepatic arterial phase and the area of positive tumor cells was statistically significant (p=0.002). VEGF may be the factor that enhances the hepatic mass with water-soluble iodinated contrast agent in CT.

Coil Embolization of Rasmussen Aneurysm Diagnosed by Helical CT: A Case Report Dae

We report a case of Rasmussen aneurysm diagnosed by helical CT that well shows vascular imaging. Coil embolization of Rasmussen aneurysm stopped the bleeding successfully.

The Imaging Findings of Small(< or =15mm) Portal Defects in the Liver on CT Arterial Portography: Evaluationwith CT Hepatic Arteriography and Lipiodol CT

PURPOSE: To assess the malignant potential of small(< or =15mm) portal defects seen on CT arterial portography,the findings of CT hepatic arteriography and lipiodol CT CT were reviewed. MATERIALS AND METHODS: In 91 patientswho underwent both CTAP and CTHA, small portal defects were re-viewed for frequency, multiplicity and location. Weprospectively evauluated changes in the size and enhance-ment pattern of malignant lesions on follow up CTaccording to density on CTHA, location, lipiodol deposits on lipiodol CT, and multiplicity. RESULTS: Among the 91patients, 102 small defects were defected in 42 patients(46%). Small portal defects were benign, malignant, and ofundetermined malignant potential in 77%, 20% and 3% of cases, respectively. Small portal defects that werehyperattenuated on CTHA, and lipiodol deposits on lipiodol CT, were malignant in 42% and 70% of cases,respectively. Location and multiplicity did not show statistically significant variation between benign andmalignant defects. CONCLUSION: Small portal defects are common and there is a high probability that portaldefects smaller than 15mm are benign, even in patients with a known hepatic mass and defect that washyperattenuated on CTHA. If a small defect showed lipiodol deposit on lipiodol CT, malignancy must be suspected.

Role of Helical CT in Early Gastric Cancer

PURPOSE: To evaluate the value of helical CT in patients with endoscopically and pathologically proven early gastric cancer. MATERIALS AND METHODS: Helical CT scans(5-mm section thickness, 5-mm/sec table speed) were obtained in 45 patients with pathologically proven early gastric cancer. CT findings were retrospectively reviewed by two independent radiologists without surgical or pathologic information. Detection rate, depth of invasion, and lymph node staging were evaluated. RESULTS: The overall detection rate was 52% ; there was no significant difference in the rates between observer A(55%) and B(49%). The detection rate was higher in the anterior bodywall(100%) and antrum(63%) than in the posterior body wall(42%) and antrum(53%). The detection rate of the depressed type(63%) was higher than that of the elevated type(38%). Submucosal stripe was seen in 45% of mucosallesions and in 32% of submucosal lesions, though the stripe was not a reliable indicator for depth of invasion.Lymph node metastasis was detected in only one of eight patients. None was found to have distant metastasis. CONCLUSION: Helical CT is of little help in the evaluation of endoscopically evident early gastric cancer and the routine use of helical CT is not recommended in early gastric cancer.