Tiny staining spots in liver cirrhosis associated with HCV infection observed by computed tomographic hepatic arteriography: follow-up study.
BACKGROUND
It is important to distinguish small lesions with increased arterial perfusion observed by computed tomographic arteriography (CT-A) from hepatocellular carcinoma (HCC). However, the clinical characteristics and prognosis of such lesions have not been clarified.


METHODS
We retrospectively examined 200 patients with cirrhosis related to hepatitis C virus (HCV) infection who had undergone both CT-A and CT arterioportography between 1995 and 1998, and found 80 tiny staining spots (TSS)s, with a diameter of 5-10 mm, by CT-A (35 patients). The mean TSS observation period was 29.0 months. If the major axis was larger than 10 mm and showed a 1.5-fold or more increase, the lesion was regarded as tumor growth (TG). The TSS lesions were divided into two groups according to whether the patient had or did not have HCC. The prognosis of TSS was classified into three groups; HCC-suspected group, nontumor group, and unclassified group, in which TG was negative although transcatheter arterial embolization (TAE) had been performed.


RESULTS
Of the 40 TSSs in 14 patients without HCC, 2 (5%) were suspected as HCC. Of the 40 TSSs in 21 patients with HCC, 13 (32.5%) were suspected as HCC. There were no significant differences in the size, position, and morphology of TSSs among the three prognostic groups. Of the 7 TSSs with a high signal intensity on T2-weighted magnetic resonance (MR) images, 5 were in the HCC-suspected group.


CONCLUSIONS
We recommend early treatment of TSSs accompanying HCC or showing features of malignancy at the imaging workup.
Tsuchiyama
Tomoya
T
Department of Gastroenterology, Kanazawa University Hospital, Kanazawa Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
Terasaki
Shuichi
S
Kaneko
Shuichi
S
Kaji
Kyosuke
K
Kobayashi
Kenichi
K
Matsui
Osamu
O
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006526:Hepatitis C / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000821:virology; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D011172:Portography; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods