Using Contrast-Enhanced Sonography to Assess the Effectiveness of Transcatheter Arterial Embolization for Hepatocellular Carcinoma
Kazushi Numata1,
Katsuaki Tanaka1,
Takayoshi Kiba1,
Satoru Saito1,
Tetsuo Isozaki1,
Koji Hara1,
Manabu Morimoto1,
Hisahiko Sekihara1,
Hiromi Yonezawa2 and
Toru Kubota3
1
Third Department of Internal Medicine, Yokohama City University School of
Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
2
Clinical Laboratory, Yokohama City University School of Medicine, Kanazawa-ku,
Yokohama 236-0004, Japan.
3
Second Department of Surgery, Yokohama City University School of Medicine,
Kanazawa-ku, Yokohama 236-0004, Japan.
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Fig. 1A. —80-year-old man with Child's class B cirrhosis and
hepatocellular carcinoma (maximum diameter, 20 mm) in superior anterior
segment of right lobe of liver. Arterial phase contrast-enhanced wideband
harmonic gray-scale sonogram after transcatheter arterial embolization shows
tumor and tumor margin (arrowheads). Note hypervascular area within
tumor (arrow).
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Fig. 1B. —80-year-old man with Child's class B cirrhosis and
hepatocellular carcinoma (maximum diameter, 20 mm) in superior anterior
segment of right lobe of liver. Portal phase contrast-enhanced wideband
harmonic gray-scale sonogram shows hypervascular area (arrow) in
tumor. Enhancement of liver parenchyma is also seen.
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Fig. 2A. —83-year-old woman with Child's class A cirrhosis and
hepatocellular carcinoma (maximum diameter, 40 mm) in superior anterior
segment of right lobe of liver. Before-treatment arterial phase
contrast-enhanced wideband harmonic gray-scale sonogram shows tumor and tumor
margin (arrowheads). Note intratumoral vessels that are tortuous
centrally in tumor (arrow).
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Fig. 2B. —83-year-old woman with Child's class A cirrhosis and
hepatocellular carcinoma (maximum diameter, 40 mm) in superior anterior
segment of right lobe of liver. Before-treatment portal phase
contrast-enhanced wideband harmonic gray-scale sonogram shows tumor and tumor
margin (arrowheads). Note that homogeneous tumor enhancement is
almost same as that of liver parenchyma.
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Fig. 3C. —63-year-old woman with Child's class B cirrhosis and
hepatocellular carcinoma (maximal diameter 30 mm) in lateral segment of left
lobe of liver. Contrast-enhanced CT scan obtained after six percutaneous
ethanol injection treatments does not show high-attenuation area. Arrowheads
indicate tumor margin.
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Fig. 3D. —63-year-old woman with Child's class B cirrhosis and
hepatocellular carcinoma (maximal diameter 30 mm) in lateral segment of left
lobe of liver. Portal phase contrast-enhanced wideband harmonic gray-scale
sonogram obtained after six percutaneous ethanol injection treatments shows
hypervascular area (arrow) in tumor.
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Fig. 2D. —83-year-old woman with Child's class A cirrhosis and
hepatocellular carcinoma (maximum diameter, 40 mm) in superior anterior
segment of right lobe of liver. Portal phase contrast-enhanced wideband
harmonic gray-scale sonogram after transcatheter arterial embolization shows
hypervascular area (arrow) in tumor. Enhancement of liver parenchyma
is also seen.
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Fig. 3B. —63-year-old woman with Child's class B cirrhosis and
hepatocellular carcinoma (maximal diameter 30 mm) in lateral segment of left
lobe of liver. Portal phase contrast-enhanced wideband harmonic gray-scale
sonogram obtained after transcatheter arterial embolization shows tumor and
tumor margin (arrowheads). Lesions that correspond to deposition of
iodized oil (arrows) do not show hypervascular enhancement; however,
surrounding lesions, free of iodized oil deposition, show hypervascular
enhancement.
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Fig. 3A. —63-year-old woman with Child's class B cirrhosis and
hepatocellular carcinoma (maximal diameter 30 mm) in lateral segment of left
lobe of liver. Contrast-enhanced CT scan obtained after transcatheter arterial
embolization shows incomplete deposition of iodized oil and surrounding
high-attenuation area (arrow) in tumor and tumor margin
(arrowheads).
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Fig. 2C. —83-year-old woman with Child's class A cirrhosis and
hepatocellular carcinoma (maximum diameter, 40 mm) in superior anterior
segment of right lobe of liver. Contrast-enhanced CT scan obtained after
transcatheter arterial embolization shows incomplete deposition of iodized
oil, such that evaluation of tumor viability is not possible because of
iodized oil accumulation in tumor (arrowheads).
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Fig. 2E. —83-year-old woman with Child's class A cirrhosis and
hepatocellular carcinoma (maximum diameter, 40 mm) in superior anterior
segment of right lobe of liver. Portal phase contrast-enhanced wideband
harmonic gray-scale sonogram obtained after additional percutaneous ethanol
injection therapy shows complete disappearance of hypervascular area within
tumor. Enhancement of liver parenchyma is seen.
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Fig. 3E. —63-year-old woman with Child's class B cirrhosis and
hepatocellular carcinoma (maximal diameter 30 mm) in lateral segment of left
lobe of liver. Portal phase contrast-enhanced wideband harmonic gray-scale
sonogram obtained after seven percutaneous ethanol injection treatments shows
that hypervascular area in tumor is no longer seen.
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Copyright © 2001 by the American Roentgen Ray Society.
