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Journal List > J Korean Radiol Soc > v.13(2) > 1137775

Chung: Angiographic manifestations of hepatocellular carcinoma of the liver

Abstract

The value of selective celiac and hepatic angio Graphy in the diagnosis of primary hepatoma of the liver hasamply been documented in the literatures. The selective angiography is useful not only for the diagnosis ofprimary hepatoma and its vascular anatomy but also for intraarterial injection of anticancerous durgs. Thefindings of selective celiac and/or hepatic arteriography in total 38 cases of confirmed hepatocelluar carcinomaof the liver, with their clinical findings, were analysed. The summarized results are as follows; 1. Incidence ofhepatoma is more common in male : male to female ratio is 34:4, and the peak age incidence is 5th to 7th decades(73.7%). About twothirds of the all patients had a clinical onset characterized by indefinite abdominal symotomessuch as epigastric discomfort, indigestion and palpable mass in right upper quadrant. The laboratory examinationsrevealed elevation of serum alkaline phosphatase more than 5 Bodansky units in 73.5% of all patients, and thealphafeto-protein was positive in 66% of all patients. 2. The simple chest PA films revealed matastatic nodules inthe lung of 5 cases and esophagograms demonstrated 8 cases of esophageal varices. 3. All 38 cases werehypervascular in the selective angiograms, and the angiography gross anatomical types were 17 cases of massivetype, 11 cases of diffuse type and 10 cases of nodular type. Most constant angiographic finding of thehepatocellular carcinoma was hypervascularity and tumor vessels (100%), and the other important findings weretumor stanings (96%), displacement of intrahepatic arteries (74%), arterioportal shunt (66%), vascular lakes andchannel (61%) and encasement of hepatic artery (26%), in orders, The portal vein regurgitation was in 7 cases andthe artery-to-hepatic vein shunt with tumor mass in hepatic vein was in one case. 4. In 28 cases of hepatomapatients, the intraarterial injection of 10mg of Mitomycin was done through the catheter after the angiographicstudies. 5. The selective hepatic and/or celiac arteriographies are one of excellent diagnostic tool ofhepatocellular carcinoma and an essential technique for intraarterial injection of anticancerous drugs in hepatomapatients.

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