Computed tomography angiographic findings in hepatocellular carcinoma less than 2 cm detected during follow-up in 29 patients.
OBJECTIVE
The early stage of hepatocarcinogenesis is not well understood pathologically and clinically. The present study was designed to define small (early) hepatocellular carcinoma (HCC) angiographically using the angio-helical computed tomography (CT) system.


METHODS
Arterial portography CT and hepatic arteriography CT were carried out in 29 patients in whom small HCC < or = 20 mm was detected during follow-up.


RESULTS
There were 17 males and 12 females, aged 47 to 85 years. The offending virus was hepatitis B in four, hepatitis C in 24 and no virus marker in one case. The follow-up period varied from less than a year to 17 years, averaging 6.4 years. The underlying disease was cirrhosis in 12 and chronic hepatitis in 17 cases. The mass was solitary in 16 and multiple in 13 cases, while the size of the mass ranged from 8-20 mm. All lesions were low in attenuation on arterial portography CT, and in 23 of 30 lesions hepatic arteriography CT showed high attenuation, suggesting arterial blood supply. In the remaining 7 cases, lesions were perhaps in the transition from portal to arterial.


CONCLUSIONS
It was concluded that HCC develops frequently in a liver with chronic hepatitis, often muticentrically, and that early HCC lesions are more often overt HCC already with arterial blood supply, rather than extremely well-differentiated supplied by the portal vein as generally believed.
Iwamoto
Shozo
S
Iwamoto Hospital, Iwamoto Clinic 1-2-8, Shimoishida, Kokuraminami-ku, Kitakyushu 802-8382, Japan.
Sanefuji
Hayato
H
Okuda
Kunio
K
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed