Radiology, Vol 165, 61-63, Copyright © 1987 by Radiological Society of North America
Metastatic nodules of hepatocellular carcinoma: detection with angiography, CT, and US
N Hayashi, K Yamamoto, N Tamaki, T Shibata, K Itoh, I Fujisawa, Y Nakano, Y Yamaoka, N Kobayashi and K Mori
Accurate detection of intrahepatic metastases, or daughter nodules, of
primary hepatocellular carcinoma is of crucial importance. Due to the
introduction of infusion hepatic angiography, computed tomography (CT)
after Lipiodol (iodized oil) infusion, and intraoperative ultrasound (US),
tumors less than 10 mm in diameter are now frequently found. We compared
the diagnostic accuracy of these three modalities in the detection of
nodules in 45 patients who had hepatocellular carcinoma (confirmed by
biopsy). CT with Lipiodol was superior to hepatic angiography in
demonstrating nodules when they were overlapped by the primary tumor or
very small in size. Intraoperative US demonstrated nodules in four
avascular or hypovascular hepatocellular carcinomas, which both hepatic
angiography and CT failed to demonstrate. In cases associated with severe
liver cirrhosis, differentiation of small nodules from regenerating
cirrhotic nodules was sometimes difficult with intraoperative US. The
combined use of these three modalities is indispensable for the accurate
detection of small nodules of metastatic hepatocellular carcinoma.
