Haemodynamic changes in hepatocellular carcinoma and liver parenchyma under balloon occlusion of the hepatic artery.
OBJECTIVE
To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion.


METHODS
Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver.


RESULTS
In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group.


CONCLUSIONS
Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion.


CONCLUSIONS
• Hepatic artery occlusion causes haemodynamic changes in hepatocellular carcinoma and liver. • Segmental occlusion decreased rate of change in hepatocellular carcinoma-to-liver attenuation ratio. • Subsegmental occlusion increased rate of change in hepatocellular carcinoma-to-liver attenuation ratio. • Hepatic artery occlusion decreased enhancement volume of hepatocellular carcinoma and liver. • Hepatic artery occlusion causes perfusion defects in hepatocellular carcinoma.
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan.
Fumie
F
Sugihara
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan. genji@nms.ac.jp.
Satoru
S
Murata
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan.
Tatsuo
T
Ueda
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan.
Daisuke
D
Yasui
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan.
Hidenori
H
Yamaguchi
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan.
Izumi
I
Miki
Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Chiaki
C
Kawamoto
Department of Surgery, Nippon Medical School, Tokyo, Japan.
Eiji
E
Uchida
Department of Radiology, Center for Advanced Medical Technology, Nippon Medical School, Tokyo, Japan.
Shin-Ichiro
SI
Kumita
D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000379:methods; D000072226:Computed Tomography Angiography / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006439:Hemodynamics / Q000502:physiology*; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D064847:Multimodal Imaging / Q000379:methods; D011446:Prospective Studies
Balloon occlusion; Haemodynamics; Hepatocellular carcinoma; Multidetector computed tomography; Therapeutic chemoembolization
Radiology. 2002 Jul;224(1):47-54
12091661
Lancet. 2012 Mar 31;379(9822):1245-55
22353262
Semin Liver Dis. 1999;19(3):329-38
10518312
World J Gastroenterol. 2014 Oct 7;20(37):13453-65
25309076
Gastroenterology. 1990 Apr;98(4):1024-8
2311859
Radiology. 2005 Oct;237(1):361-5
16118153
Cardiovasc Intervent Radiol. 2013 Jun;36(3):706-13
22996589
Am J Surg. 1966 Sep;112(3):337-47
5917302
Hepatol Res. 2015 Jun;45(6):663-6
25132539
Nihon Igaku Hoshasen Gakkai Zasshi. 1981;41(9):894-6
7335481
Hepatogastroenterology. 1995 Feb;42(1):18-21
7782028
PLoS One. 2014 Jul 21;9(7):e103009
25047920
Radiology. 1975 Oct;117(1):49-54
1162072
Hepatology. 2003 Feb;37(2):429-42
12540794
Radiographics. 1995 Sep;15(5):1089-102
7501852
CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
21296855
Acta Radiol. 1997 Sep;38(5):836-9
9332240
Hepatology. 2002 May;35(5):1164-71
11981766
Hepatology. 2005 Nov;42(5):1208-36
16250051
Radiology. 1982 Sep;144(4):835-9
6287520
J Hepatol. 2012 Apr;56(4):908-43
22424438
Hepatogastroenterology. 2005 May-Jun;52(63):852-6
15966219
Radiology. 1998 Oct;209(1):121-8
9769822