目的:为了确定频率,在高危患者中进行肝细胞癌(HCC)监测的腹骨盆CT报告的偶然盆腔发现的特征和临床意义。
方法:这项双中心回顾性研究获得了机构审查委员会的批准,并放弃了知情同意。对2010年1月1日至2023年2月28日用于HCC监测的CT检查的放射学报告进行了审查。使用静脉造影材料进行检查,包括腹部的肝动脉和门静脉阶段;在门静脉阶段获取骨盆图像。放射科医师或相应护理人员报告的影像学发现和影像学相关建议,如果存在,进行回顾性列表。对患者的医疗记录进行审查,以确定是否有任何建议被认为是临床重要的,并最终导致任何进一步的干预或治疗。
结果:259名成年人(第一中心:平均年龄,60±11岁,49%男性和第二中心:56.26±6.2岁,48%的男性)在两个中心接受了327个腹部盆腔CT检查以进行HCC监测。总共622个骨盆发现(平均值,2.2/考试)被报告,包括131个膀胱,120消化道,133个血管,51妇科,37前列腺,33淋巴结,27腹股沟,44腹膜,46骨骼。622个报告发现中的52个(8.3%)与可操作的建议相关。52项可行建议/临床建议中的24项实施如下:5项免费成像,十项额外的实验室测试,和九项非影像学建议。值得注意的是,只有八项应用建议最终得出了临床结果,其中包括四种尿路感染治疗。
结论:在1.3%的检查中,盆腔CT表现与患者的临床获益相关。这些结果表明,基于CT的HCC监测应省略盆腔成像。
结论:在不损害有价值信息的情况下,接受HCC监测-CT的患者可能不需要额外的盆腔覆盖.
OBJECTIVE: To determine the frequency, characteristics and clinical significance of incidental
pelvic findings reported on abdominopelvic CT performed for hepatocellular carcinoma (HCC) surveillance in at-risk patients.
METHODS: This two-center retrospective study received institutional review board approval with a waiver of informed consent. The radiologic reports of the CT exams performed 1/1/2010-2/28/2023 for HCC surveillance were reviewed. Exams were obtained with intravenous contrast material and included hepatic arterial and portal venous phases of the abdomen; images of the pelvis were acquired during the portal venous phase. Reported imaging findings and imaging-related recommendations either by the radiologists or the corresponding caregiver, if present, were retrospectively tabulated. The patient\'s medical records were reviewed to determine if there were any recommendations that were considered clinically important and culminated in any further interventions or treatments.
RESULTS: 259 adults (1st center: mean age, 60 ± 11 years, 49% male and 2nd center: 56.26 ± 6.2 years, 48% male) at risk for HCC underwent 327 abdominopelvic CT exams for HCC surveillance at two centers. A total of 622
pelvic findings (mean, 2.2/ exam) were reported, including 131 bladder, 120 alimentary tract, 133 vascular, 51 gynecologic, 37 prostate, 33 lymph node, 27 inguinal, 44 peritoneal, and 46 skeletal. 52 of 622 reported findings (8.3%) were associated with actionable recommendations. 24 of the 52 actionable recommendations/clinical suggestions were implemented as follows: five complimentary imaging, ten additional laboratory tests, and nine non-imaging recommendations. Of note, only eight applied recommendations culminated in a clinical outcome, which included four urinary tract infection treatments.
CONCLUSIONS: Pelvic CT findings were associated with a clinical benefit to the patient in 1.3% of exams. These results suggest that
pelvic imaging should be omitted from CT-based HCC surveillance.
CONCLUSIONS: Without compromising valuable information, patients undergoing HCC surveillance-CT may not require additional
pelvic coverage.