Lipiodol Enhanced CT Scanning of Malignant Hepatic Thmors
CHARINDR EURVILAICHIT, B.Sc., M.D.*
Affiliation : *Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400. Thailand.
The patients comprised 30 cases of hepatocellular carcinoma, 4 cases of cholangio- carcinoma and 7 cases of metastatic tumors of which one was from CA stomach, three were from CA breast, and three from CA colon. The vascularity of the tumor was assessed in angiogram obtained prior to treatment and retention pattern of lipiodol in the tumor was evaluated in lipiodol-enhanced CT scan images taken 2-4 weeks following therapy.
The results showed that lipiodol CT scan images exhibited four patterns of lipiodol retention in the tumor appearing as opacity as follows (l) homogenous (2) heterogeneous (3) ring - like and (4) none. Lipiodol retention pattern appeared to be somewhat related to vascularity of the tumor. Most of the hypervascular tumors such as hepatocellular carcinoma had homogeneous lipiodol accumulation pattern if the tumor size was less than 5 em. Metastatic tumors and cholangiocarcinoma showed heterogeneous or ring - like pattern of lipiodol accu- mulation because they were relatively hypovascular. Hypervascular hepatocellular carcinoma may exhibit heterogeneous or ring - like pattern if they are larger than 5 ems, and have multiple feeding arteries, necrosis or A V shunting. Hepatocellular carcinoma with A V shunting may not show any lipiodol accumulation at all.
Keywords : Lipiodol CT Scan, Malignant Hepatic Tumors
