Published online Jun 15, 1999. doi: 10.3748/wjg.v5.i3.225
Revised: November 22, 1998
Accepted: February 6, 1999
Published online: June 15, 1999
AIM: To recognize the characteristic findings of micro-liver cancer (MLC) and to evaluate the effect of CT arterial portography (CTAP) and CT hepatic arteriography (CTHA) in diagnosis of MLC.
METHODS: Between April 1996 to December 1998, CTAP and CTHA were performed in 12 patients with MLC, which were not detected by conventional CT examinations. After CTHA, 3 mL-5 mL mixture of lipiodol, doxorubicin and mitoycin C were injected into hepatic artery through the catheter, and the followed up by CT three or four weeks later (Lipiodol CT Lp-CT).
RESULTS: A total of 22 micro-tumors (0.2 cm-0.6 cm in diameter) were detected in 12 patients, which manifested as small perfusion defects in CTAP and small round enhancement in CTHA. The rate of detectability of CTAP and CTHA was 68.2% (15/22) and 77.3% (17/22) respectively, and the rate of the simultaneous use of both procedures reached 86.4% (19/22). All micro-tumors were demonstrated as punctate lipiodol deposit foci in Lp-CT. After Lp-CT, the elevated serum level of α-fetoprotein (AFP) dropped to the normal level in all patients.
CONCLUSION: The CTAP and CTHA are the most sensitive imaging methods for detecting micro-liver cancer. Confirmed by the change of the elevated serum AFP level and lipiodol deposit foci in Lp-CT, small perfusion defects in CTAP and puntuate enhancement in CTHA may suggest micro-liver cancer.