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The Incidences and Related CT Features of Vascular Lake Phenomenon on Angiography Before Chemoembolization

  • Clinical Investigation
  • Imaging
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To elucidate incidence rates of vascular lake phenomenon (VLP) in hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), hepatic metastasis (HMT) on transarterial angiography before chemoembolization, and to identity CT features predictive for it.

Materials and Methods

A comprehensive evaluation involved 665 subjects for incidence analysis, comprising 527 of HCC, 33 of ICC and 105 of HMT. VLP was characterized as intratumoral contrast material pool persisting late into venous phase. Incidences were cataloged on both super-selective and common hepatic artery angiography. For CT features analysis, a subset of 182 cases were analyzed. Enhancement ratio served as an index for comparative analysis of nodule enhancement degrees.

Results

In HCC, incidence of VLP ascertained via super-selective angiography was 13.5%, whereas it as 7.8% on common hepatic artery angiography. Remarkably, no incidences of VLP were recorded in either ICC or HMT cases. On pre-interventional CT, the prevalence of pseudocapsule was statistically greater in VLP group than Non-VLP group (66.6% vs. 37.6%, P = 0.015). The Houndsfield units (HU) of tumors in plain scan (P = 0.007), arterial phase (P = 0.001), venous phase (P = 0.041), arterial phase enhancement ratio (P < 0.001) were statistically higher in VLP group compared to Non-VLP group. Arterial phase enhancement ratio (P = 0.025), presence of pseudocapsule (P = 0.001), HU of tumor in plain scan (P = 0.035) serve as independent risk factors for VLP manifestation.

Conclusion

VLP is a distinct angiography phenomenon uniquely associated with HCC. High arterial phase enhancement ratio, presence of pseudocapsule, high HU of tumor in plain scan are independent risk factors for VLP.

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Authors and Affiliations

  1. Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, No.188 Shizi Street, Suzhou, 215006, Jiangsu, China

    Kai-Lun Yang, Xin-Yu Mao, Jian Shen, Jian-Wei Zou, Ming-Ming Li & Zhi Li

  2. Department of Radiology, Affiliated Lianyungang Hospital of Xuzhou Medical University, No.6 Zhenhuadong Road, Lianyungang, 222061, Jiangsu, China

    Kai-Lun Yang

  3. Department of Interventional Radiology, Suzhou Xiangcheng People’s Hospital, No. 1060 Huayuan Road, Suzhou, 215131, China

    Ya-Pan Guo

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Contributions

Yang KL and Guo YP contributed equally as the co-first authors.

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Correspondence to Zhi Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Yang, KL., Guo, YP., Mao, XY. et al. The Incidences and Related CT Features of Vascular Lake Phenomenon on Angiography Before Chemoembolization. Cardiovasc Intervent Radiol 47, 225–233 (2024). https://doi.org/10.1007/s00270-023-03651-3

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  • DOI: https://doi.org/10.1007/s00270-023-03651-3

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