Evaluation of Preoperative CT Findings after Transcatheter Arterial Embolization using Lipiodol in Hepatocellular Carcinoma

Tohru Segawa, Kunihide Izawa, Shigeki Tokunaga, Kazuhide Ura, Teiji Matsumoto, Toshifumi Eto, Koichi Motoshima, Tsukasa Tsunoda, Ryoichi Tsuchiya

Second Department of Surgery, Nagasaki University School of Medicine

Preoperative CT scans obtained after transcatheter arterial embolization using Lipiodol and gelatin sponge (Lp-CT) in 30 patients with resected hepatocellular carcinoma (HCC) were reviewed. The findings of preoperative Lp-CT were compared with macro-and microscopic findings of the resected specimen in this study. There were 27 males and 3 females. The mean age was 59.5 years. The accumulation pattern of Lipiodol (Lp) in the main tumors on CT was divided into 4 types according to the extent of Lp accumulation: type I, diffuse type (16 cases); type II, mottled type (7); type III, spotty type (4); type IV, minute type (3). Small nodules of the cancer were often seen in type I, while large nodules were often found in type IV. Serum α-fetoprotein levels after transchatheter arterial embolization with Lp (Lp-TAE) were reduced in 80% of the cases in type I, 50% in II, 25% in III and 80% in IV. The mean necrotic rate of the main tumor was 79.6% in I, 52.1% in II, 13.8% in III, 63.3% in IV. Seven cases, all of whom were type I, showed complete necrosis of the main tumor in the resected specimen. The necrotic rate of trabecular type HCC was higher than that of solid, pseudoglandular type. CT findings after Lp-TAE can be helpful to elucidate the effects of Lp-TAE on hepatocellular carcinoma.

Key words
hepatocellular carcinoma, transcatheter arterial embolization using lipiodol and gelatin sponge, computed tomography after transcatheter arterial embolization using lipiodol and gelatin sponge, accumulation rate, necrotic rate

Reprint requests
Tohru Segawa Second Department of Surgery, Nagasaki University School of Medicine
7-1 Sakamoto-machi, Nagasaki, 852 JAPAN

Accepted
September 12, 1990

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