CLINICAL EVALUATION OF ANGIOGRAPHIC PORTAL VEIN FINDINGS AND OPERABILITY IN HEPATOCELLULAR CARCINOMA

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Angiographic findings in 50 cases of hepatocellular carcinoma (HCC), 27 of these received hepatectomy, were analyzed in an attempt to obtain the relation between the portal vein findings, operability and prognosis. The portal vein findings of HCC were devided into two groups; normal and abnormal groups.Furthermore, the abnormal portal vein findings were classified into 5 groups; regurgitation, collateral vein, thread and streaks, filling defect and not opacified main portal vein branch.The abnormal portal vein findings in HCC were considered to be due to tumor thrombus in portal vein and observed in 36 cases (74%).In 20 of these 36 cases, the histological examinations of portal vein were carried out, and tumor thrombus in portal vein was found to be present in all these cases.In 36 cases of HCC with abnormal portal vein findings, 19 cases were inoperable because of intrahepatic metastasis or big tumor, but superselective hepatic angiography did not always reveal intrahepatic metastasis in these cases.In 14 of 36 cases, hepatectomy was done in HCC with the abnormal portal vein findings, but recurrence was high and the prognosis was poor.In contrast, 13 cases of HCC who had the good opacification of main portal vein branch (normal portal vein findings) were received operation with good prognosis.These data indicate that angiographic portal vein findings by portal vein angiography are very important to decide the operability in patients with HCC, in addition to the observation obtained by hepatic angiography.
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CLINICAL EVALUATION OF ANGIOGRAPHIC PORTAL VEIN FINDINGS AND OPERABILITY IN HEPATOCELLULAR CARCINOMA

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