Molecular Mechanism and Blood Flow Imaging of the Formation of Angioarchitech titure during the Occurrence and Progression of Hepatocellular Carcinoma.

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1. Change of Intranodular Blood Flow During the Occurrence and Multistep Progression of Hepatocellular Carcinoma.Hepatocellular carcinoma(HCC)occurs as a hyperplastic nodule at its initiation of cancer. During multistep progression, hyperplastic nodule develops to the early well-differentiated HCC, and finally to advanced moderately differentiated HCC.Consistent with this progression, intranodular hemodynamic also changes, from arterially hypovascular and portally iso-perfusion(type I)to hypoperfusion state both from artery and portal vein(type II). Then it develops to the isovascular(type III)and to the classical hypervascular HCC(type II). This alteration can be detected by in vivo vascular imagings, such as US angiography, CTA, and CTAP.2. Hemodynamic AnalysisIn addition to invasive vascular imaging, contrast harmonic imaging with intravenous injection of ultrasound contrast agent is extremely useful in the detection of intra nodular vascularity, both arterial and portal venous flow.