Arteriography in diagnosing hepatocellular carcinoma.
The diagnostic role of arteriography in the evaluation of hepatocellular carcinoma is pointed out. In the identification of large lesions angiography achieves a sensitivity of 100%. However, when evaluating small lesions (under 5 or 3 cm in diameter), the sensitivity is reported to be 82-89%. To increase the sensitivity, different special techniques have been developed which require angiographic placement of a catheter. These include CT arteriography, CT arterial portography and CT after intraarterial injection of iodized oil. Particularly with the two latter techniques, the sensitivity in identification of small hepatocellular carcinoma reaches a value of 91-95%. Angiography can also be proposed for the characterization of neoplastic lesions in cirrhotic livers. Its specificity is 72% in the differential diagnosis of hepatocellular carcinoma and adenomatous hyperplastic nodules. Small grade I hepatocellular carcinoma can simulate this benign lesion at angiography, as well as at histology. Finally, angiography may still play a role in the preoperative staging of hepatocellular carcinoma both for the diagnosis of satellite lesions and for the identification of vascular invasion.
Pavone
P
P
Cattedra di Radiologia, Università dell'Aquila, Italy.
Marsili
L
L
Petroni
G A
GA
Cardone
G
G
Cisternino
S
S
Di Girolamo
M
M
Passariello
R
R
D000792:Angiography / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D002406:Catheterization, Peripheral / Q000379:methods; D002445:Celiac Artery; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D008638:Mesenteric Arteries; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed / Q000379:methods
D007459:Iodized Oil