Arterial CT in the diagnosis of hepatocellular carcinoma: initial experience with 12 patients

Intra-arterial CT of the liver is a valuable method to evaluate hepatocellular carcinoma (HCC). It consists of an infusion of contrast medium into the hepatic artery during CT scanning. Twelve patients with suspected resectable HCCs were evaluated with CT arteriography before surgery. The results of CT arteriography were compared with those of US, of CT with intravenous contrast medium and of angiography; on the rule, all exams had been performed some days earlier. The diagnosis of HCC was confirmed by US-guided fine-needle biopsy. CT arteriography demonstrated liver lesions in 11 patients. The lesions were hyperdense in 3/11 patients (27.3%) and hypodense and surrounded by a hyperdense ring in 8/11 patients (72.7%). In 4 of 11 patients (36.4%) CT arteriography identified additional tumor nodules and thus surgery was excluded. In the latter cases, on the basis of CT arteriographic findings, US, CT with i.v. contrast medium and angiography were repeated but failed to demonstrate the additional nodules, either because they were too small or because of cirrhotic changes in liver parenchyma. Therefore, CT arteriography is recommended in the evaluation of selected patients, especially when detailed information on liver parenchyma is needed--e.g., before surgery. In these patients CT arteriography can be performed together with preoperative angiography.