[The indication of hepatic resection from medical imaging technique for hepatocellular carcinoma]

Recently small hepatocellular carcinoma are frequently diagnosed due to the improvement of medical imaging techniques. Main tumors including one with diameter of 1 cm were definitely diagnosed by the combined use of US and CT. US and angiographic examination were useful in definitely detecting tumor emboli in the main trunk even to the subsegmental level of the portal vein. All of the 12 daughter nodules of diameter over 1 cm could be definitely diagnosed by any examinations. However, diagnostic accuracy was in detecting 11 daughter nodules of diameter below 1 cm as the following data shown; one was positive using US, six were positive using CT, and three were positive using angiography. Sequential moving scan technique during the late phase could make definite preoperative diagnosis of small daughter nodule of diameter below 1 cm. Owing to the improvement of the imaging diagnostic technique, we can obtain accurate preoperative information concerning the presence or absence of daughter nodule and tumor emboli in the portal vein. Therefore, we can select suitable candidates for surgical excision or other combined therapy.