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Recent developments in imaging diagnostics for HCC: CT arteriography and CT arterioportography evaluation of vascular changes in premalignant and malignant hepatic nodules

  • Hiroshi Honda
  • Tsuyoshi Tajima
  • Kenichi Taguchi
  • Toshiro Kuroiwa
  • Kengo Yoshimitsu
  • Hiroyuki Irie
  • Hitoshi Aibe
  • Kenji Shinozaki
  • Yoshiki Asayama
  • Mitsuo Shimada
  • Kouji Masuda
Topics: Progress in diagnosis and treatment of hepatocellular carcinoma

Abstract:

We analyzed the hemodynamic properties and vascular supply changes in relation to the carcinogenesis of hepatocellular carcinoma (HCC), selecting 18 premalignant and malignant nodules less than 3 cm diameter (from 14 patients) for our study. The computed tomographic (CT) arteriography and CT arterioportography (CTAP) findings for these nodules were correlated with the histopathologic findings. The ratios of all microscopically counted arteries (normal hepatic and abnormal arteries), normal hepatic arteries, and portal veins in each nodule to those in the surrounding liver were calculated. Well differentiated lesions had low attenuation on CT arteriography and isoattenuation on CTAP. Moderately-to-poorly differentiated lesions had high attenuation on CT arteriography and low attenuation on CTAP. In well differentiated lesions, the ratios of all arteries, normal hepatic arteries, and portal veins were 1.17 ± 0.10, 0.66 ± 0.12, and 0.80 ± 0.10, respectively. In moderately-to-poorly differentiated lesions, the ratios were 2.64 ± 0.23, 0.09 ± 0.03, and 0.07 ± 0.03, respectively. We concluded that blood flow does not parallel the actual number of arteries seen on the histological examination of tumors. In well differentiated lesions, the combination of normal hepatic arterial degeneration and preserved portal veins results in low attenuation on CT arteriography and isoattenuation on CTAP. In advanced HCC, the combination of neoplastic (abnormal) arterial development by angiogenesis and obliteration of portal veins results in high attenuation on CTA and low attenuation on CTAP. These findings are characteristic of early and advanced stage HCC, and may reflect a combination of sequential changes in their hemodynamic states.

Keywords

Compute Tomographic Hepatocellular Carcinoma Portal Vein Vascular Supply Hemodynamic State 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Tokyo 2000

Authors and Affiliations

  • Hiroshi Honda
    • 2
  • Tsuyoshi Tajima
    • 1
  • Kenichi Taguchi
    • 2
  • Toshiro Kuroiwa
    • 1
  • Kengo Yoshimitsu
    • 1
  • Hiroyuki Irie
    • 1
  • Hitoshi Aibe
    • 1
  • Kenji Shinozaki
    • 1
  • Yoshiki Asayama
    • 2
  • Mitsuo Shimada
    • 3
  • Kouji Masuda
    • 1
  1. 1.Department of Radiology, Faculty of Medicine, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, JapanJP
  2. 2.Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, JapanJP
  3. 3.Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, JapanJP

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