背景：对于治疗后进行CT随访的肝细胞癌（HCC）患者，常规包含盆腔覆盖的益处尚未得到充分证实。 目的：研究在治疗后进行肝脏CT随访时，包括盆腔覆盖对于检测HCC患者的盆腔转移或偶发肿瘤的附加价值。 材料和方法：本次回顾性研究纳入2016年1月至2017年12月被诊断患有HCC并在治疗后接受肝脏CT随访的患者。使用Kaplan-Meier方法估计局部外转移、独立盆腔转移和偶发盆腔肿瘤的累积率。Cox比例风险模型用于确定额外的肝外和独立的盆腔转移的风险因素。还计算了盆腔覆盖所产生的辐射剂量。 结果：共纳入1122例患者（平均年龄60岁±10 [标准差]；896男）。3年内局部外转移、独立盆腔转移和偶发盆腔肿瘤的累积率分别为14.4%，1.4%和0.5%。经过调整分析，以维生素K缺乏或拮抗-II所致的蛋白（P = .001）、最大肿瘤大小（P = .02）、T级（P = .008）和初始治疗方法（P < .001）与局部外转移有关。只有T级与独立盆腔转移有关（P = .01）。由于盆腔覆盖，与没有盆腔覆盖的CT扫描相比，有和无造影剂增强的肝脏CT扫描的辐射剂量分别增加了29%和39%。 结论：对于治疗后的肝细胞癌患者，独立盆腔转移或偶发盆腔肿瘤的发生率较低。© RSNA，2023年。

Background In patients with hepatocellular carcinoma (HCC) who undergo follow-up with CT after treatment, the benefit of routinely including pelvic coverage is not well substantiated. Purpose To investigate the added value of pelvic coverage at follow-up liver CT in detecting pelvic metastasis or incidental tumors in patients treated for HCC. Materials and Methods This retrospective study included patients who were diagnosed with HCC between January 2016 and December 2017 and followed up with liver CT after treatment. Cumulative rates of extrahepatic metastasis, isolated pelvic metastasis, and incidental pelvic tumor were estimated by using the Kaplan-Meier method. Cox proportional hazard models were used to identify risk factors for extrahepatic and isolated pelvic metastases. Radiation dose from pelvic coverage was also calculated. Results A total of 1122 patients (mean age, 60 years ± 10 [SD]; 896 men) were included. The cumulative rates at 3 years of extrahepatic metastasis, isolated pelvic metastasis, and incidental pelvic tumor were 14.4%, 1.4%, and 0.5%, respectively. At adjusted analysis, protein induced by vitamin K absence or antagonist-II (P = .001), size of the largest tumor (P = .02), T stage (P = .008), and initial treatment method (P < .001) were associated with extrahepatic metastasis. Only T stage was associated with isolated pelvic metastasis (P = .01). Because of pelvic coverage, the radiation dose increased by 29% and 39% in liver CT with and without contrast enhancement, respectively, compared with CT scans without pelvic coverage. Conclusion The incidence of isolated pelvic metastasis or incidental pelvic tumor was low in patients treated for hepatocellular carcinoma. © RSNA, 2023.