Dysplastic nodules in liver cirrhosis: Evaluation of hemodynamics with CT during arterial portography and CT hepatic arteriography

PURPOSE: To evaluate the portal and arterial blood supplies to dysplastic n odules in the cirrhotic liver with computed tomography (CT) during arterial portography (CTAP) and CT hepatic arteriography (CTHA). MATERIALS AND METHODS: Nineteen histopathologically proved low-grade dyspla stic nodules and 13 high-grade dysplastic nodules in 17 patients with liver cirrhosis were evaluated with CTAP acid CTHA for the presence of portal an d arterial blood supplies to the nodules. The nodules ranged from 0.4 to 4. 5 cm in diameter (mean, 1.6 cm). RESULTS: The portal supply was present in 14 of the 19 (74%) low-grade dysp lastic nodules and in seven of the 13 (54%) high-grade dysplastic nodules. The hepatic arterial supply was increased in four of the 19 (21%) low-grade dysplastic nodules, present in nine (47%), and absent in six (32%). The ar terial supply was increased in four of the 13 (31%) high-grade dysplastic n odules, present in four (31%), and absent in five (38%). CONCLUSION: The portal and arterial supplies to the low- and high-grade dys plastic nodules were variable and inconsistent. Therefore, it is difficult to detect and characterize the dysplastic nodules on the radiologic images on the basis of the blood supply.