Computed tomographic arteriography of the liver using balloon occlusion

The article describes a new method for computed tomographic arteriography (CTA) of hepatocellular carcinoma (HCC) using a balloon occlusion catheter in 8 patients. Our dynamic study indicated that: 1) a bolus injection of contrast medium with our method of CTA (CTA-B) produced an attenuation difference between liver and tumor which was about double that obtained with standard methods for CTA, and 2) marked tumor-liver attenuation differences (above 20 HU) persisted for more than 60 s in CTA-B and for not more than 20 s with conventional methods for CTA. The results show that CTA-B is superior to standard methods in enabling multiple scans of the liver during greater and prolonged differential tumor enhancement after administration of a bolus of contrast medium. In conjunction with table incrementation, CTA-B allows scanning of the entire liver at the time of maximal contrast enhancement with two to three injections of contrast medium. Two patients complained of abdominal pain during balloon inflation. No other complications were observed.