6 research outputs found
(A) study of imaging diagnosis in the primary hapatocellular carcinoma
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[μλ¬Έ]
The Primaly hepatocellular carcinoma(HCC) is one of the most prevalent malignancy in Korea and its prognosis is poor. The poor prognosis is attributed to the large tumor sixe, multiple sites of origin and the coexistence of cirrhosis that is frequently found at the time of diagnosis. Early diagnosis is therefore of prime importance in the treatment of Hcc and is indeed a crucial challenge to the clinician and radiologist.
Reviwed here retrospectively 147 patients who were diagnosed as the primary HCC by operation or ultrasonoguided neddle aspiration biopsy or clinically by increased alphafetoprotein at the Severance Hospital from September, 1984 through August, 1987, in respective of detection rate of radionuclide imaging(RN),ultrasonography(US), computed tomography(CT) and angiography(Angio), especially about small HCC(β€3cm), morphological patterns, findings of US, CT and Angio, and
following results were obtained.
1. The overall detection rate of RN, US, CT and Angio were 130/143 cases (90.9%), 137/144 cases(95.1%), 132/144 cases(97.1%), 131/134 cases(97.8%), respectively.
2. The detection rate of RN, US, CT and Angio in small HCC were 8/11 cases(72.7%), 9/11 cases(81.9%), 9/11 cases(90.0%), 10/11 cases (90.1%), respectively.
3. The morphological pattern of HCC showed unifocal mass 56 cases (38.1%), multifocal masses 64 cases (43.5%) and diffuse infiltrative type 27 cases (18.4%).
4. The underlying liver cirrhosis was demonstrated in 76 cases(51.7%) and detected more commonly in massive type of unifocal mass greater than 10 cm and diffuse infiltrative type.
5. US show low echogenic mass 14 cases(10.2%), discrete echogenic mass with halo 23 cases(16.8%), discrete echogenic mass without halo 3 cases(2.2%), mixed echogenic mass 34 cases (24.8%), ill defined echogenic mass 49 crises (35.8%) and
disoirganized hepatic parenchyma without discrete lesion 15 cases (10.4%).
6. CT show hypodense tumor 125 cases(94.7%), isodense tumor 7 cases (5.3%), central necrosis 84 cases(63.6%), venous invasion 44 cases(33.3%), lymph node metastases 17 cartes (12.9%), calcification 5 cases(3.8%) and pedunculated hepatoma 15 cases(11.4%).
7. Angiographically, hypervascular HCCs were 116 cases(88.5%), hypovascular HCCs were 15 cases(11.5%). Tumor vessels 117 cases(89.3%), tumor stain 112 cases(85.5%), arterial encasement 99 cases(75.6%), arterial displacement 73 cases(55.7%), arteriovenous shunt 78 cases(59.5%), arterioportal shunt 67 cases(51.1%), portal vein invasion 47 cases(35.9%) and additional mass not detected in US or 14 cases (10.7%).
In conclusion, the ultrasonography is suggested as initial scereening imaging Modality due to high detection rate of small HCC and usefulness of ultrasonoguided needle aspiration biopsy in necessary. CT, noninvasive method, is recommended in order to known exact tumor location and extension or distant metastasis.
Angiography should be used as a supplement in uncertain cases and nay add valuable information in the differential diagnosis. It Is needed for the preoperative demonstraction of the Vascular anatomy. The radiologic diagnosis must still be confirmed by biopsy.restrictio