Usefulness & Pitfalls in CT Arterioportography

ABSTRACT

PURPOSE: To evaluate the usefulness, patterns and appearances of false positive lesions, and technical problems of CTAP(CT Arterioportography). MATERIALS AND METHODS: CTAP was done in 45 patients in whom hepatic lesions were suggested on other radiologic studies. CTAP findings were compared with the informations obtained by operations, biopsies, and follow-up imagings. Additional findings, which were not detected in other radiologic studies, false positive manifestations, and technical errors were analyzed. RESULTS: CTAP detected 51 additional hepatic lesions which are not detected in other imaging studies. Of the 51 lesions, ten were true positive hepatic tumors, 2 were inflammatory lesions and 39 were false positive .lesions. False positive lesions included perfusion defects of periportal and perifissural areas, subcapsular perfusion defects and nonlobar, nonsegmental geographic perfusion defects. In 2 cases, CTAP aided in deciding the surgical strategy. On the other hand, there were 4 cases causing interpretational confusion and 6 cases of improper imaging due to technical errors. CONCLUSION: CTAP was valuable in detection of additional hepatic cancer lesion as well as in making the treatment plan. However, since many false positive lesions and improper imaging due to technical error occur during the examination, the understanding of such problems is essential for correct interpretation of CTAP.