The origin of blood supply for cavernous hemangioma of the liver.
OBJECTIVE
To investigate the origin of blood supply to cavernous hemangioma of the liver (CHL).


METHODS
To observe the relation of cavernous hemangioma of the liver to the hepatic artery and portal vein, we performed serial selective hepatic arteriography in 22 patients. Five patients after ligation of the right hepatic arteries underwent portography and liver staining by injection of methylene blue into the portal veins and 2 patients had hepatic specimens resected, which were made into a model cast by filling the hepatic veins (yellow) and portal venous branches (blue) with methyl methacrylate after vascular lavage.


RESULTS
Serial selective hepatic arteriography showed that hepatic arteries and hemangioma were displayed simultaneously, and that hemangioma was supplied by one to numerous arterial branches. In the portal phase of portography, contrast medium failed to enter the tumor and the intrahepatic branches of the portal vein were pushed aside by the tumor; in the liver parenchymal phase, however, the tumor appeared to be a low-density area. Hepatic arteriography and portography revealed that the fistula between the artery and portal vein may not be existed. The liver stained with methylene blue showed that the normal hepatic parenchyma could be stained with deep blue; in contrast, the tumor was not stained at all. The casting specimens showed that the eroded tumor left a round vacant area because of its total shedding, and no blue stained branches of the portal vein extended into the tumor.


CONCLUSIONS
Blood supply of CHL may originate from the hepatic artery.
Li
Guo-Wei
GW
Department of General Surgery, Second Hospital Xi'an Jiaotong University, Xi'an 710004, China. liguowei1964@sina.com
Chen
Qi-Long
QL
Jiang
Jian-Tao
JT
Zhao
Zhong-Rong
ZR
D000328:Adult; D000792:Angiography; D005260:Female; D006392:Hemangioma, Cavernous / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006499:Hepatic Artery; D006801:Humans; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein