To determine the value of angiography in predicting liver metastasis of colorectal cancers, 128 colorectal cancers (71 colon cancer cases, 57 rectal cancer caces) were examined preoperatively using angiography focused on the mesenteric vessels around the primary lesion.
The findings obtained by angiography were compared with occurrence of liver metastasis and the histopathological findings.
Synchronic liver metastasis was present in 17 cases, and heterochronic metastasis in 16 cases. Liver metastasis was detected in 62.5 % of the cases with invasion of the truncal artery, 37.0 % of the cases with invasion of the marginal veins and 57.7% of cases with invasion of the truncal vein.
The cases were classified according to the morphological type of the terminal of vasa recta into 5 groups ; unchanged, dendroid, frizzled, feathery, and tufted. Liver metastasis was present in 63.3 % of the tufted group.
Liver metastasis was more frequent in the cases in which both arterial and venous phase angiograms showed dilatation of the vessels within the lesion than in those without dilatation. It was present in 55.5 % of the cases in which angiograms showed pooling of veins within the lesion.
Histologically, liver metastasis was present in only 1.6 % of the cases without venous invasion, while it was present in 35.3 % of those with venous invasion.
Tufted type of vessels and liver metastasis were frequently observed, in moderately differentiated adenocarcinoma.
In the present study, no particular findings distinguishing synchronic liver metastasis from heterochronic metastasis were obtained except for histological venous invasion. This suggests that heterochronic metastasis was present, even though it could not be detected at the time of operation.
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