HYPERVASCULAR HEPATOCELLULAR-CARCINOMA - EVALUATION OF HEMODYNAMICS WITH DYNAMIC CT DURING HEPATIC ARTERIOGRAPHY

PURPOSE: To assess the hemodynamics and the main drainage vessel of hy pervascular hepatocellular carcinoma. MATERIALS AND METHODS: Single-le vel dynamic computed tomography during hepatic arteriography (CTHA) wa s performed in 32 patients with hepatocellular carcinoma. Carcinoma wa s confirmed with histologic (n = 9) or clinical (n = 23) examination r esults. Single-level CTHA findings was retrospectively analyzed. Histo logic specimens from 40 livers with hepatocellular carcinoma were also examined, with special attention to vessels along the rim of the lesi on. RESULTS: Contrast material enhancement of single-level CTHA images occurred in four phases: (a) inflow of the contrast material into tum or, (b) tumor enhancement, (c) inflow of the contrast material into ad jacent liver, and (d) corona enhancement of adjacent liver. Corona enh ancement was seen in all lesions. A bright branching structure in the corona enhancement area, suggestive of a portal venule, was visible at the start of adjacent liver staining in 21 lesions. Continuity betwee n a tumor sinusoid and a tiny vessel in the inner layer of the pseudoc apsule was histologically confirmed in 10 of 40 specimens. Continuity between a tiny vessel in the inner layer and a portal vein in the oute r layer of the pseudocapsule was confirmed with findings on serial sec tions from one liver. CONCLUSION: The main drainage of hepatocellular carcinoma lesions may be a portal venule.