ANGIOGRAPHIC DIAGNOSIS OF SMALL HEPATOCELLULAR CARCINOMA

Significance of Tumor Stain in the Diagnosis of Small Hepatocellular Carcinoma

Abstract

Angiographic findings of hepatocellular carcinoma (HCC) less than 50mm in diameter were evaluated. In angiographic diagnosis of small HCC, abnormal findings were rare in the arterial phase, and tumor stains in the capillary to venous phase were the only findings, especially in HCC smaller than 20mm. Tumor stains consisted of staining and non-staining areas. There was no interrelationship between the degree of tumor stains and the width of histological blood sinusoids of the tumor. The non-staining area of the tumor stains had pathological backgrounds of necrosis, fibrosis and fatty degeneration. Slow growing HCC demonstrated round and homogeneous tumor stains. Tumor stains in angiography clearly delineated the tumor growth and extension in cases of hepatocellular carcinoma, and also proved to be important in the angiographic diagnosis of small HCC. Tumor stains were obtained in 42 cases out of 51(82.4%) cases of hepatocellular carcinoma, and in blind evaluation of tumor stains of HCC, metastatic liver carcinoma and hemangioma, an overall accuracy of 92.1% was obtained. In order to obtain consistent tumor stains, it is necessary to perform infusion hepatic angiography super-selectively. However infusion angiography induced tumor-like stains in all 7 cases of liver cirrhosis without HCC. Therefore careful deferentiation between HCC and cirrhotic nodules is mandatory.