Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Seoul 110-744, Korea.
Korean J Radiol. 2011 Nov-Dec;12(6):693-9. doi: 10.3348/kjr.2011.12.6.693. Epub 2011 Sep 27.
To predict which intercostal artery supplies a tumor by examining the spatial relationship between hepatocellular carcinoma (HCC) and the intercostal artery feeding the tumor on transverse computed tomography (CT) images.
Between January 2000 and September 2009, 46 intercostal arteries supplying HCCs smaller than 4 cm were noted in 44 patients, and CT scans and angiograms of these patients were retrospectively reviewed. The intercostal artery feeding the tumor was marked on the CT scan showing the center of the tumor. In addition, its spatial relationship with the tumor center was examined. The angle of the tumor location was measured on the transverse CT scan in the clockwise direction from the sagittal line on the virtual circle centered in the right hemithorax. Correlations between the angle of the tumor location and the level of the tumor-feeding intercostal artery were assessed with the Spearman rank coefficient.
Of 46 intercostal arteries feeding HCC, 39 (85%) were the first ones observed from the tumor center in a counterclockwise direction on the transverse CT image containing the tumor center. The level of the tumor-feeding intercostal artery was significantly correlated with the angle of the tumor, as the posteriorly located tumor tends to be supplied by lower intercostal arteries, while the laterally located tumor by upper intercostal arteries (Spearman coefficient = -0.537; p < 0.001).
We can predict the tumor feeder with an accuracy of 85% as the first intercostal artery encountered from the tumor center in a counterclockwise direction on a transverse CT image.
通过检查肝细胞癌（HCC）与供应肿瘤的肋间动脉在横断 CT 图像上的空间关系，预测哪根肋间动脉供应肿瘤。
2000 年 1 月至 2009 年 9 月期间，在 44 例 HCC 直径小于 4cm 的患者中，共发现 46 支供应 HCC 的肋间动脉，回顾性分析这些患者的 CT 扫描和血管造影图像。在显示肿瘤中心的 CT 扫描上标记供应肿瘤的肋间动脉，并检查其与肿瘤中心的空间关系。在横断 CT 扫描上，以顺时针方向从右半胸虚拟圆的矢状线开始测量肿瘤位置的角度。用 Spearman 秩相关系数评估肿瘤位置角度与肿瘤供养肋间动脉水平之间的相关性。
在供应 HCC 的 46 支肋间动脉中，39 支（85%）在包含肿瘤中心的横断 CT 图像上，从肿瘤中心逆时针方向观察到的第一支肋间动脉。肿瘤供养肋间动脉的水平与肿瘤的角度有显著相关性，因为位置靠后的肿瘤往往由较低的肋间动脉供应，而位置靠外侧的肿瘤则由较高的肋间动脉供应（Spearman 系数=-0.537，p<0.001）。
我们可以通过在横断 CT 图像上，从肿瘤中心逆时针方向观察到的第一支肋间动脉，以 85%的准确率预测肿瘤供养动脉。
