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Dysplastic Nodules in Liver Cirrhosis: Evaluation of Hemodynamics with CT during Arterial Portography and CT Hepatic Arteriography¹

¹ From the Departments of Radiology (J.H.L., J.M.C., E.Y.K.) and Diagnostic Pathology (C.K.P.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea. Received March 17, 1999; revision requested May 3; revision received June 7; accepted July 23. Address reprint requests to J.H.L. (e-mail: jhlim@smc.samsung.co.kr).

PURPOSE: To evaluate the portal and arterial blood supplies to dysplastic nodules in the cirrhotic liver with computed tomography (CT) during arterial portography (CTAP) and CT hepatic arteriography (CTHA).

MATERIALS AND METHODS: Nineteen histopathologically proved low-grade dysplastic nodules and 13 high-grade dysplastic nodules in 17 patients with liver cirrhosis were evaluated with CTAP and CTHA for the presence of portal and arterial blood supplies to the nodules. The nodules ranged from 0.4 to 4.5 cm in diameter (mean, 1.6 cm).

RESULTS: The portal supply was present in 14 of the 19 (74%) low-grade dysplastic nodules and in seven of the 13 (54%) high-grade dysplastic nodules. The hepatic arterial supply was increased in four of the 19 (21%) low-grade dysplastic nodules, present in nine (47%), and absent in six (32%). The arterial supply was increased in four of the 13 (31%) high-grade dysplastic nodules, present in four (31%), and absent in five (38%).

CONCLUSION: The portal and arterial supplies to the low- and high-grade dysplastic nodules were variable and inconsistent. Therefore, it is difficult to detect and characterize the dysplastic nodules on the radiologic images on the basis of the blood supply.

Index terms: Liver, blood supply, 95.92 • Liver, cirrhosis, 761.794 • Liver, CT, 761.12114, 761.12115, 761.12116 • Liver, nodules, 761.3198, 761.323 • Liver neoplasms, angiography, 951.122, 955.122 • Liver neoplasms, diagnosis, 761.3198, 761.323

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