Computed tomographic arteriography in the diagnosis of hepatocellular carcinoma

Computed tomographic arteriography (CTA) was performed in 30 patients with hepatocellular carcinoma (HCC). Detection of HCC by CTA was compared with that of conventional celiac or hepatic arteriography. CT scanning was performed immediately, 30 seconds and 1 min after an injection of 5 to 10 ml of contrast medium into the common or proper hepatic artery. Repeated infusions allowed whole liver sections to be visualized. HCC was localized in 28 of the 30 patients by conventional arteriography, with CTA detecting the masses in 27 of the 28 patients. CTA imaging presented the tumor mass in 1 of the 2 patients missed by arteriography. Conventional arteriography delineated the boundaries of HCC in 15 (50%) of the 30 patients. CTA clearly delineated the masses in 26 (87%) of the 30 patients including 11 patients in which the tumor borders were obscure by conventional arteriography. HCC lesions smaller than 1 cm in diameter were detected only by CTA in 6 (20%) of the patients. It was concluded that CTA is both useful and necessary in the demarcation of small HCC masses.