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[Imaging diagnosis of ruptured site in hepatocellular carcinoma]
Insights
Identifying ruptured hepatocellular carcinoma (HCC) sites is crucial for effective treatment. Imaging methods like US, CT, and angiography can help diagnose rupture, reducing liver failure risks from transarterial embolization (TAE).
Area of Science:
- Hepatobiliary Imaging
- Interventional Radiology
- Hepatocellular Carcinoma Research
Background:
- Rupture of hepatocellular carcinoma (HCC) is a frequent cause of mortality.
- Effective management of ruptured HCC requires precise identification of the bleeding site for emergent transarterial embolization (TAE).
- Preventing liver failure post-TAE is critical in managing ruptured HCC.
Purpose of the Study:
- To evaluate the diagnostic utility of ultrasonography (US), computed tomography (CT), and angiography in identifying ruptured sites of HCC.
- To assess the combined diagnostic yield of these imaging modalities for ruptured HCC.
- To determine if accurate diagnosis of rupture can mitigate hepatic failure following emergent TAE.
Main Methods:
- Retrospective analysis of 18 patients with ruptured HCC.
- Evaluation of diagnostic findings from US, rapid CT, lipiodol CT, and angiography.
- Correlation of imaging findings with confirmed ruptured sites.
Main Results:
- Ultrasonography identified ruptured sites in 26.7% (4/15) of cases.
- Rapid CT detected intraperitoneal bleeding in 16.7% (3/18) of cases; lipiodol CT showed characteristic leakage.
- Angiography visualized extravasation in 15.4% (2/13) of cases.
- Overall, imaging diagnosed the ruptured site in 44.4% (8/18) of patients.
Conclusions:
- Combined imaging modalities offer a significant diagnostic capability for ruptured HCC.
- Accurate localization of bleeding in ruptured HCC is achievable through various imaging techniques.
- Improved diagnosis of ruptured HCC sites can potentially reduce the incidence of liver failure associated with emergent TAE.
Abstract:
Rupture causes frequently the patients with HCC to death. Then it is important to investigate ruptured site of HCC in order to stop bleeding effectively and safely by emergent TAE without causing liver failure. We evaluate the usefulness of 3 major imaging method, such as US, CT and angiography in our 18 cases of HCC. In ultrasonography, ruptured site was shown as the high echoic area localized around the tumor in 4/15 cases (26.7%). In computed tomography of rapid scanning, it was shown as the intraperitoneal high density area around the tumor in 3/18 cases (16.7%). And lipiodol CT showed the characteristic leakage in the abdominal cavity. In angiography, it was shown as the extravasation of contrast material only in 2/13 cases (15.4%). In the results, it was possible to diagnose the ruptured site in 8/18 cases (44.4%) by using these procedures. Diagnosis of ruptured site will make it possible to reduce the frequency of hepatic failure caused by emergent TAE.