SMALL HEPATOCELLULAR-CARCINOMA - EVALUATION OF PORTAL BLOOD-FLOW WITHCT DURING ARTERIAL PORTOGRAPHY PERFORMED WITH BALLOON OCCLUSION OF THE HEPATIC-ARTERY

PURPOSE: To evaluate portal blood flow in small hepatocellular carcino mas (HCCs) by means of computed tomography during arterial portography (CTAP) and CTAP with hepatic arterial obstruction (CTP-HAO) achieved by means of balloon occlusion. MATERIALS AND METHODS: Thirteen patient s with small HCC (< 20 mm in diameter) underwent CTAP, CTP-HAO, carbon dioxide-enhanced ultrasound (CEUS), and digital subtraction angiograp hy (DSA). The imaging findings were correlated with histologic feature s. RESULTS: The first group of patients (n = 3) had tumors with portal blood flow at both CTAP and CTP-HAO and no hypervascularity at CEUS. The second group (n = 3) had tumors with portal blood flow at CTP-HAO but not at CTAP and hypervascularity at CEUS only. The third group (n = 7) had tumors without portal blood flow at CTAP or CTP-HAO and hyper vascularity at DSA and CEUS. The first and second groups had well-diff erentiated HCCs; six of seven patients in the third group had moderate ly differentiated HCCs. CONCLUSION: Lack of portal blood now was rever sible in well-differentiated HCCs but irreversible in the other tumors .