The radiological diagnosis of hepatoma with special emphasis on angiography.

The radiological findings of 69 out of a total of 81 cases of proven primary hepatocellular carcinoma are reviewed retrospectively. Selective angiography was performed on 42 patients and the results are analysed according to specific angiographic findings and distribution of the neoplasm, Because of the more aggressive approach to surgical treatment of hepatomas, angiography is of utmost importance in the pre-operative evaluation of the extent of the lesion and the vascular supply to the liver. Apart from the conventional angiogram, the technique of slow-infusion hepatic angiography is discussed as well as the value of enhancement techniques such as photographic subtraction and the use of vasoconstrictor drugs. Response to chemotherapy can be assessed by an infusion hepatic angiogram if a catheter has been surgically placed in the hepatic artery. The majority of tumours were easily disgnosed on the angiogram but special problems were encountered in distinguishing multicentric forms of hepatoma from hepatic metastases and avascular lesions from primary cholangiocarcinoma. The wide variety of clinical and angiographic findings that may be found, are emphasised in 4 brief case repots.