Sequential hemodynamic change in hepatocellular carcinoma and dysplastic nodules: CT angiography and pathologic correlation

Tsuyoshi Tajima, Hiroshi Honda, Kenichi Taguchi, Yoshiki Asayama, Toshirou Kuroiwa, Kengo Yoshimitsu, Hiroyuki Irie, Hitoshi Aibe, Mitsuo Shimada, Kouji Masuda

    Research output: Contribution to journalArticlepeer-review

    137 Citations (Scopus)

    Abstract

    OBJECTIVE. The purpose of this study was to clarify the hemodynamic changes associated with hepatocarcinogenesis using CT angiography. MATERIALS AND METHODS. Eighty-six hepatocellular lesions were confirmed at pathology in 49 patients who underwent CT with both hepatic arteriography and arterioportography. These images were compared with lesion-to-liver vascular ratios of cumulative arteries, preexisting hepatic arteries, and portal veins in resected specimens. Lesions were classified in five groups according to intranodular hemodynamics determined by CT hepatic arteriography and CT during arterioportography: group 1, isoattenuating on both procedures; group 2, hypoattenuating on CT hepatic arteriography and isoattenuating on CT during arterioportography; group 3, hypoattenuating on both procedures; group 4, isoattenuating on CT hepatic arteriography and hypoattenuating on CT during arterioportography; and group 5, hyperattenuating on CT hepatic arteriography and hypoattenuating on CT during arterioportography. RESULTS. Among 86 lesions, we identified seven low-grade dysplastic nodules, eight high-grade dysplastic nodules, 14 well-differentiated hepatocellular carcinomas, 45 moderately differentiated hepatocellular carcinomas, and 12 poorly differentiated hepatocellular carcinomas. The lesions were classified as group 1 (n = 5), group 2 (n = 13), group 3 (n = 6), group 4 (n = 2), or group 5 (n = 60). Intranodular hemodynamics was significantly correlated with pathologic grading (p < 0.001). For correlations between combinations of the groups and pathologic gradings, the order "groups 1-2-3-4-5" was the most significant (p < 0.001). CONCLUSION. During hepatocarcinogenesis, most hepatocellular nodules show deterioration of arterial blood flow before loss of portal blood flow. Vascular imaging of hepatic nodules may predict malignant abnormality via the early loss of hepatic arterial flow seen before portal flow changes.

    Original languageEnglish
    Pages (from-to)885-897
    Number of pages13
    JournalAmerican Journal of Roentgenology
    Volume178
    Issue number4
    DOIs
    Publication statusPublished - 2002

    All Science Journal Classification (ASJC) codes

    • Radiology Nuclear Medicine and imaging

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