Significance of Angio-CT on Diagnosis for Hepatocellular Carcinoma and Precancerous Lesions -From the Point of Hepatectomy for Hepatocellular Carcinoma with Liver Cirrhosis-

Kazuo Hatsuse, Hideki Aoki, Michinori Murayama, Tsukasa Aihara, Kenji Tsuboi, Minoru Kakihara, Syoetsu Tamakuma, Toshiyuki Irie*, Shintarou Terahata**

First Department of Surgery, Radiology*, Clinical Laboratory**, National Defense Medical College

Fifteen patients with space occupying lesions detected by ultrasonography or computed tomography in the course of follow-up for liver cirrhosis underwent hepatic resection after computed tomography during angiography (angio-CT). Detectability and diagnostic value of angio-CT for intrahepatic tumor were evaluated in comparison with conventional imaging techniques including digital subtraction angiography (DSA), magnetic resonance imaging (MRI) and lipiodol CT (Lp-CT). Twenty-three lesions detected in 15 patients were as follows: 14 hepatocellular carcinoma (HCC), 3 adenomatous hyperplasia (AH), one early hepatocellular carcinoma (eHCC), one atypical adenomatous hyperplasia (AAH), one regenerative nodule, and 3 miscellaneous lesions. With regard to 8 patients with 2 lesions, there were 2 AHs in one patient and 4 patients with advanced HCC had small HCC, eHCC, AH and AAH, respectively. These findings are suggestive of the presence of multicentric carcinogenesis in cirrhosis. The detection rate for intrahepatic tumors was 86.9% with angio-CT, 56.5% with DSA, 71.4% with MRI and 50% with Lp-CT. The detection rate for eHCC, AH and AAH was 80% with angio-CT, and 20% with DSA, MRI and Lp-CT. Angio-CT visualized AH regarded as a precancerous lesion and eHCC more frequently than other imaging techniques. The above mentioned data suggested that there was such a frequent occurrence of multicentric carcinogenesis that recognition of precancerous lesion by angio-CT was important in surgical intervention for HCC with liver cirrhosis.

Key words
liver cirrhosis, hepatocellular carcinoma, nodular lesions mimicking hepatocellular carcinoma, multicentric carcinogenesis in liver cirrhosis, computed tomography during hepatic arteriography or arterioportography

Reprint requests
Kazuo Hatsuse First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
March 2, 1994

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