Small hepatocellular carcinoma: evaluation of portal blood flow with CT during arterial portography performed with balloon occlusion of the hepatic artery.
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.
Saitoh
S
S
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
Ikeda
K
K
Koida
I
I
Tsubota
A
A
Arase
Y
Y
Chayama
K
K
Kumada
H
H
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