Dynamic hepatic CT.

A technique for incremental dynamic computed tomography (CT) of the liver with boluses of contrast material (with a 50-g iodine load) administered intravenously is described. For most focal liver lesions, which are hypovascular in relation to normal hepatic parenchyma, bolus contrast material enhancement and incremental dynamic scanning improve detectability, compared with that yielded by nondynamic, contrast material infusion techniques. The bolus contrast-enhanced dynamic scan technique is reproducible and of value in patients undergoing sequential CT for assessment of tumor bulk response to chemotherapy. Patients who are potential candidates for resection of focal hepatic lesions should preoperatively undergo intraarterial contrast-enhanced CT. Intravenous bolus enhanced dynamic hepatic CT can be extended to cover more than one anatomic region (eg, abdomen and thorax), as in patients undergoing CT for staging lung carcinoma. In these patients, incremental scan sequences are programmed caudad to cephalad. Incremental dynamic CT is also an appropriate technique to use in cooperative patients who have suffered blunt abdominal trauma.