Hypervascular hepatocellular carcinoma: evaluation of hemodynamics with dynamic CT during hepatic arteriography.
OBJECTIVE
To assess the hemodynamics and the main drainage vessel of hypervascular hepatocellular carcinoma.


METHODS
Single-level dynamic computed tomography during hepatic arteriography (CTHA) was performed in 32 patients with hepatocellular carcinoma. Carcinoma was confirmed with histologic (n = 9) or clinical (n = 23) examination results. Single-level CTHA findings were retrospectively analyzed. Histologic specimens from 40 livers with hepatocellular carcinoma were also examined, with special attention to vessels along the rim of the lesion.


RESULTS
Contrast material enhancement on single-level CTHA images occurred in four phases: (a) inflow of the contrast material into tumor, (b) tumor enhancement, (c) inflow of the contrast material into adjacent liver, and (d) corona enhancement of adjacent liver. Corona enhancement was seen in all lesions. A bright branching structure in the corona enhancement area, suggestive of a portal venule, was visible at the start of adjacent liver staining in 21 lesions. Continuity between a tumor sinusoid and a tiny vessel in the inner layer of the pseudocapsule was histologically confirmed in 10 of 40 specimens. Continuity between a tiny vessel in the inner layer and a portal vein in the outer layer of the pseudocapsule was confirmed with findings on serial sections from one liver.


CONCLUSIONS
The main drainage of hepatocellular carcinoma lesions may be a protal venule.
Ueda
K
K
Department of Radiology, Kanazawa University School of Medicine, Japan.
Matsui
O
O
Kawamori
Y
Y
Nakanuma
Y
Y
Kadoya
M
M
Yoshikawa
J
J
Gabata
T
T
Nonomura
A
A
Takashima
T
T
D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging; D008102:Liver Circulation / Q000502:physiology; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011168:Portal System / Q000000981:diagnostic imaging; D011169:Portal Vein / Q000000981:diagnostic imaging; D011172:Portography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014699:Venules
D003287:Contrast Media