title: Small hepatocellular carcinoma: evaluation of portal blood flow with CT during arterial portography performed with balloon occlusion of the hepatic artery.
abstract: OBJECTIVE
  To evaluate portal blood flow in small hepatocellular carcinomas (HCCs) by means of computed tomography during arterial portography (CTAP) and CTAP with hepatic arterial obstruction (CTP-HAO) achieved by means of balloon occlusion.
  
  
  METHODS
  Thirteen patients with small HCC (< 20 mm in diameter) underwent CTAP, CTP-HAO, carbon dioxide-enhanced ultrasound (CEUS), and digital subtraction angiography (DSA). The imaging findings were correlated with histologic features.
  
  
  RESULTS
  The first group of patients (n = 3) had tumors with portal blood flow at both CTAP and CTP-HAO and no hypervascularity at CEUS. The second group (n = 3) had tumors with portal blood flow at CTP-HAO but not at CTAP and hypervascularity at CEUS only. The third group (n = 7) had tumors without portal blood flow at CTAP or CTP-HAO and hypervascularity at DSA and CEUS. The first and second groups had well-differentiated HCCs; six of seven patients in the third group had moderately differentiated HCCs.
  
  
  CONCLUSIONS
  Lack of portal blood flow was reversible in well-differentiated HCCs but irreversible in the other tumors.
authors.affiliation: Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Saitoh
authors.forename: K
authors.initials: K
authors.lastname: Ikeda
authors.forename: I
authors.initials: I
authors.lastname: Koida
authors.forename: A
authors.initials: A
authors.lastname: Tsubota
authors.forename: Y
authors.initials: Y
authors.lastname: Arase
authors.forename: K
authors.initials: K
authors.lastname: Chayama
authors.forename: H
authors.initials: H
authors.lastname: Kumada
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002404:Catheterization; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008102:Liver Circulation / Q000502:physiology*; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011172:Portography / Q000379:methods; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography