Radiology, Vol 195, 371-377, Copyright © 1995 by Radiological Society of North America

ARTICLES

Therapeutic effect of percutaneous ethanol injection on small hepatocellular carcinoma: evaluation with CT

M Ebara, K Kita, N Sugiura, M Yoshikawa, H Fukuda, M Ohto, F Kondo and Y Kondo
First Department of Medicine, School of Medicine, Chiba University, Japan.

PURPOSE: To evaluate the therapeutic effect of percutaneous ethanol injection (PEI) on small hepatocellular carcinoma (HCC) with computed tomography (CT). MATERIALS AND METHODS: Sixty-seven patients with histologically proved HCC 3 cm or less in diameter underwent PEI. The patients were regularly followed up with sonography and contrast material-enhanced CT for more than 1 year (range, 12-96 months). The CT findings were evaluated for three tumor types distinguished on the basis of their appearance relative to that of the surrounding liver parenchyma: type 1 = hyperattenuating at the early phase (n = 39), type 2 = iso- or hypoattenuating at the early phase and hypoattenuating at the late phase (n = 18), and type 3 = isoattenuating (not detected) at both the early and late phases (n = 10). RESULTS: After PEI, a necrotic area of HCC and the surrounding liver parenchyma was characterized as hypoattenuating at both early and late phases of contrast-enhanced CT, regardless of the type. When an HCC appeared to be completely necrotic within 3 months after PEI, this status was retained until the latest observation in all but three cases. CONCLUSION: Contrast-enhanced CT can correctly depict PEI-induced necrosis in HCC and is reliable for evaluating the therapeutic effect of PEI.

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