Hypervascular hepatocellular carcinoma: Evaluation of hemodynamics with dynamic CT during hepatic arteriography
Hypervascular hepatocellular carcinoma: Evaluation of hemodynamics with dynamic CT during hepatic arteriography
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DOI：
10.1148/radiology.206.1.9423667
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发表时间：
1998-01-01
期刊：
影响因子：
19.7
通讯作者：
Takashima, T
中科院分区：
文献类型：
--
作者：
Ueda, K;Matsui, O;Takashima, T
目得：材料与方法：对32例肝动脉造影（CTHA）中的原发性肝癌患者行单平面动态CT检查。经组织学（n = 9）或临床（n = 23）检查结果证实为癌。回顾性分析单节段CTHA结果。组织学标本40例肝细胞癌进行了检查，特别注意血管沿着边缘的lesion.Results：造影剂增强的单级CTHA图像发生在四个阶段：（a）流入的造影剂进入肿瘤，（B）肿瘤增强，（c）流入的造影剂进入邻近的肝脏，（d）冠状增强邻近的肝脏。所有病变均可见冠状强化。在21个病灶的邻近肝脏染色开始时，在冠状增强区可见明亮的分支结构，提示门静脉。40例标本中有10例在组织学上证实了肿瘤窦状隙和假包膜内层的微小血管之间的连续性。内层的微小血管和外层的假包膜的门静脉之间的连续性被证实与一个肝脏的连续切片的结果。结论：肝癌病变的主要引流可能是门静脉。
PURPOSE: To assess the hemodynamics and the main drainage vessel of hypervascular hepatocellular carcinoma.MATERIALS AND METHODS: Single-level dynamic computed tomography during hepatic arteriography (CTHA) was performed in 32 patients with hepatocellular carcinoma. Carcinoma was confirmed with histologic (n = 9) or clinical (n = 23) examination results. Single-level CTHA findings was retrospectively analyzed. Histologic specimens from 40 livers with hepatocellular carcinoma were also examined, with special attention to vessels along the rim of the lesion.RESULTS: Contrast material enhancement of single-level CTHA images occurred in four phases: (a) inflow of the contrast material into tumor, (b) tumor enhancement, (c) inflow of the contrast material into adjacent liver, and (d) corona enhancement of adjacent liver. Corona enhancement 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 between a tumor sinusoid and a tiny vessel in the inner layer of the pseudocapsule was histologically confirmed in 10 of 40 specimens. Continuity between a tiny vessel in the inner layer and a portal vein in the outer layer of the pseudocapsule was confirmed with findings on serial sections from one liver.CONCLUSION: The main drainage of hepatocellular carcinoma lesions may be a portal venule.