Hepatocellular carcinoma: CT appearance of parenchymal changes after percutaneous ethanol injection therapy.

Abstract

PURPOSE: To evaluate the changes in surrounding liver parenchyma after treatment of hepatocellular carcinoma (HCC) and borderline malignant lesions with percutaneous ethanol injection (PEI). MATERIALS AND METHODS: The authors reviewed the findings at computed tomography (CT) and CT during arterial portography (CTAP) obtained before and after PEI therapy for 32 lesions in 26 patients with HCC or adenomatous hyperplasia. Two surgically resected specimens were also histologically examined. RESULTS: In 10 (77%) of 13 lesions, decreased portal vein-related enhancement indicative of reduced portal blood flow in the periphery of the tumor was found at CTAP. Mild atrophy (concave liver surface), segmental atrophy, and lobar atrophy were found in 40%, 17%, and 3%, respectively. Histologic examination of the resected specimens revealed organized thrombi in the peripheral portal vein in the surrounding liver. CONCLUSION: PEI may cause decreased portal blood flow and atrophy in the noncancerous liver parenchyma that surrounds the tumor being treated.