Sumida M, Ohto M, Ebara M, Kimura K, Okuda K, Hirooka N
AJR Am J Roentgenol. 1986 Sep;147(3):531-6. doi: 10.2214/ajr.147.3.531.
Conventional hepatic arteriography combined with superselective infusion arteriography was carried out in 51 patients with hepatocellular carcinoma smaller than 5 cm, and angiograms of varying phases were analyzed. In cancers smaller than 40 mm, particularly in those smaller than 20 mm, so-called tumor stain in the capillary phase was the only abnormality seen in most but not all cases. Within a tumor stain, there were unstained areas in most cases and histologic examination in resected specimens showed them to be due to either necrosis, fibrosis, or fatty changes. Homogeneity and shape of the stain seemed to be related to growth speed and invasiveness of the cancer. Although overall diagnostic value of angiography for small hepatocellular carcinoma was high, super-superselective infusion hepatic arteriography produced nodular stains in 7 of 11 control cases of nonalcoholic cirrhosis without cancer, making difficult the differential diagnosis between stains due to tumors and those due to hyperplastic nodules of cirrhosis.
对51例直径小于5cm的肝细胞癌患者进行了传统肝动脉造影联合超选择性灌注动脉造影，并分析了不同时期的血管造影图像。在直径小于40mm的癌灶中，尤其是小于20mm的癌灶，多数（但并非所有）病例在毛细血管期可见所谓的肿瘤染色，这是唯一的异常表现。在肿瘤染色区内，多数病例存在未染色区域，切除标本的组织学检查显示这些区域是由坏死、纤维化或脂肪变性所致。染色的均匀性和形态似乎与癌症的生长速度和侵袭性有关。尽管血管造影对小肝细胞癌的总体诊断价值较高，但在11例无癌的非酒精性肝硬化对照病例中，超超选择性灌注肝动脉造影有7例出现结节状染色，这使得肿瘤染色与肝硬化增生结节染色之间的鉴别诊断变得困难。
