Delayed hepatic CT (DH-CT) was studied in 250 patients without any major bile duct pathology. One hundred thirty-five of these patients had liver metastases. All patients were administrated 76 grams of iodine. Tolerance of the examination was good. Six hours after injection, average contrast enhancement in the normal liver was 24 HU (greater than 1.3 g/kg iodine), 22 HU (1 to 1.3 g/kg) and 14 HU (1 g/kg). Comparison of scans taken before, immediately after, and 6 hours post-injection revealed the frequent superiority of postinjection scans for diagnosis of liver metastases. Focal steatosis is the only benign pathology to benefit from DH-CT, because of the parallelism in the difference in density between the normal and steatotic tissue regardless of the time of scanning. Aside from isolated tumors requiring exploration by conventional CT (pre- and post-contrast studies), the workup of liver metastases can be optimized by postcontrast and DH-CT scans.

Three hundred cases of cervical adenopathies were reviewed in connection with head and neck cancers (205 patients) and lymphoma (95 patients). Overall, physical examination failed to detect such adenopathies in 83 cases. The echostructure of the cervical node was less echoic than that of the muscles in 111 cases (58 cases of lymphoma, 53 cases of metastasis), more echoic than the muscles in 185 cases (35 cases of lymphoma, 150 cases of metastasis), and nucrotic in 4 cases (2 cases of lymphoma and 2 cases of metastasis). Jugular vein thrombosis was noted in 78 cases (75 cases of metastasis, 3 cases of lymphoma); jugular vein compression without thrombosis was observed in 65 cases (35 cases of metastasis, 30 cases of lymphoma). Before histologic proof is obtained, jugular thrombosis suggests a diagnosis of metastasis, regardless of node size. The presence of nodular intraparotid lesions (12 cases) suggests lymphoma. By contrast, neither node size nor echostructure suggest the etiology of cervical adenopathies.

In this review of 139 cancers of the cervix uteri and 43 cancers of the corpus uteri, the authors compare clinical, sonographic and CT data. For the 58 patients with cervical cancer who presented infiltration of the parametrium at physical examination under general anesthesia, sonography gave 11 false negative errors while CT gave 8 false positives. By contrast, for the 47 tumors staged IIb after examination under general anesthesia, sonography disclosed additional abnormalities in 20 cases and CT in 22 cases. A series of 52 disease recurrences in patients who had received curative treatment for uterine cancer was also reviewed; overall, an association of physical examination and ultrasonography had the same value as CT. In light of these results, the authors propose an algorithm for the exploration of uterine cancers in which the results of physical examination condition examination by ultrasonography or CT.