CT arterial portography and CT hepatic arteriography in detection of micro liver cancer

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, 3mL-5mL 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 (0.2cm-0.6cm 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 alpha-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.