Changes in contrast enhancement of hepatocellular carcinoma and liver: effect of temporary occlusion of a hepatic vein evaluated with spiral CT.
OBJECTIVE
To assess the hemodynamics of the liver and of hepatocellular carcinomas (HCCs) with hepatic vein occlusion.


METHODS
Selected hepatic veins were temporarily occluded with a balloon catheter in 21 patients with 28 nontreated nodular HCCs. Computed tomographic (CT) arteriography was performed without and with temporary occlusion of a hepatic vein that drained the blood from segmental liver parenchyma containing tumor by using a unified spiral CT and angiography system. The degree of enhancement and change in appearance of the HCC in each condition were compared.


RESULTS
All HCCs were well-enhanced, almost round masses at CT arteriography. At CT arteriography with hepatic vein occlusion, however, HCCs were changed as follows: (a) the absolute attenuation of the HCC was decreased in 27 (96%) of 28 tumors compared with that at CT arteriography without hepatic vein occlusion, while attenuation of the surrounding liver parenchyma was increased; (b) the size of the highly enhanced area in HCC became smaller in 17 (61%) tumors (of these, two disappeared); and (c) the shape was changed in 12 (43%) tumors.


CONCLUSIONS
Hepatic vein occlusion resulted in reciprocal hemodynamic changes in the liver parenchyma relative to HCCs: Enhancement of the liver increases and that of HCCs decreases.
Murata
S
S
Department of Radiology, University of Tsukuba, Japan.
Itai
Y
Y
Satake
M
M
Asato
M
M
Kobayashi
H
H
Eguchi
N
N
Moriyama
N
N
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging*; D002404:Catheterization; D003287:Contrast Media; D005260:Female; D006503:Hepatic Veins / Q000502:physiology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media