Hepatocellular carcinoma: detection of blood supply from the right inferior phrenic artery by the use of multi-detector row CT.
OBJECTIVE
To evaluate retrospectively the ability of multi-detector row computed tomography (CT) to detect blood supply from the right inferior phrenic artery (RIPA) in patients with hepatocellular carcinoma (HCC).


METHODS
Between July 2006 and June 2007, angiography of the RIPA was performed in 178 patients (151 men, 27 women; mean age, 59 years) with HCC who also had undergone multi-detector row CT. CT scans and digital subtraction angiograms of these patients were retrospectively reviewed by consensus by two investigators to evaluate tumor feeder vessels.


RESULTS
Tumor staining fed by the RIPA was noted on angiography in 113 patients (63%). Readers interpreted that the tumor feeder vessels were evident on CT images in 63 of these 113 patients (56%). Young age (odds ratio [OR], 0.934; P < .0001), exophytic growth pattern (OR, 2.702; P = .009), and presence of a visible feeder vessel on CT (OR, 6.933; P < .0001) were significant factors for predicting parasitic blood supply from the RIPA. In a subgroup of tumors smaller than 5 cm, multivariate analysis revealed that young age (OR, 0.94; P = .03) and repeated chemoembolization sessions (OR, 8.65; P = .01) were significant factors.


CONCLUSIONS
Visualization of a tumor feeding vessel from the RIPA on multi-detector row CT could be a clue of a parasitic supply of a large tumor. In patients who have received repeated chemoembolization, small tumors in the dorsal hepatic area can be supplied by the RIPA.
Kim
Hyo-Cheol
HC
Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
Chung
Jin Wook
JW
An
Sangbu
S
Son
Kyu Ri
KR
Jae
Hwan Jun
HJ
Park
Jae Hyung
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult