BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is becoming one of the common malignant tumors worldwide, and it is characterized by its high vascularity. Caveolin is the major structural protein in caveolae, which are small omega-shaped invaginations within the plasma membrane. Caveolin has been implicated in mitogenic signaling, oncogenesis and angiogenesis. The expression of caveolin-1 and -2 in HCC and its potential relationship with angiogenesis has not been examined. METHODS: Paraffin sections of 35 HCC specimens were immunostained with caveolin-1, caveolin-2, alpha-smooth muscle actin, and CD34 antibodies. In addition, the expression of caveolin-1 and -2 mRNA in HCC was examined. The relationship between the radiological findings and the number of unpaired arteries and microvessel density (MVD) was also investigated. RESULTS: Caveolin-1 and -2 were expressed in the sinusoidal endothelial cells in 20 out of 35, and 18 out of 35 HCC specimens, respectively. Caveolin-1 and -2 were also expressed in the smooth muscle cells of the unpaired arteries in 26 out of 35, and 18 out of 35 HCC specimens, respectively. Increased expression of caveolin-1 and -2 mRNA was detected in 26.7% and 33.3% of the tumor specimens, respectively, compared with the corresponding non-tumorous adjacent liver tissues. There was a significant correlation between expression of caveolin-1, -2 in the smooth muscle cells of unpaired arteries and the number of unpaired arteries. The number of unpaired arteries in HCCs was found to be associated with the degree of contrast enhancement in the arterial phase imaging. However, it did not correlate with the degree of MVD. CONCLUSIONS: These findings suggest that the expression of caveolin-1, -2 is associated with the formation of unpaired arteries in HCC. In addition, there is a correlation between the degree of contrast enhancement of the HCC in the arterial phase image and the number of unpaired arteries.
Adult ; Aged ; Carcinoma, Hepatocellular/*blood supply/metabolism/radiography ; Caveolin 1/genetics/*metabolism ; Caveolin 2/genetics/*metabolism ; Female ; Hepatic Artery/pathology/radiography ; Humans ; Liver Neoplasms/*blood supply/metabolism/radiography ; Male ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic/etiology/*metabolism/radiography ; Retrospective Studies

OBJECTIVETo establish New Zealand rabbit hepatoma models with VX2 cell line, and modify the hepatic artery catheterization technique.

METHODSForty New Zealand rabbit models bearing hepatoma were established by implanting VX2 cells into the left and right liver lobes. Two weeks after the tumor cell implantation, 26 rabbits in the experimental group underwent modified hepatic artery catheterization procedures using microsurgical technique, and 10 rabbits in the control group were catheterized with 3F micro-catheter using Seldinger technique. The VX2 hepatomas were observed before and after the catheterization with multi-slice spiral CT scan and digital subtractive angiography (DSA).

RESULTSTumor growth after the tumor cell implantation was confirmed in 36 rabbits by CT scans and open operations. The success rate of catheterization was 88% (23/26) in the experimental group, and 40% (4/10) in the control group. VX2 hepatomas appeared as hypointense or isointense nodules on multi-slice spiral CT, and hepatic artery angiography showed that VX2 hepatomas had homogeneous or nodular tumor staining.

CONCLUSIONThe modified hepatic artery catheterization using microsurgical technique has higher success rate than catheterization with 3F micro-catheter by Seldinger technique, and significantly decreases X-ray exposure for the staff undertaking the operations.

Animals ; Carcinoma, Hepatocellular ; pathology ; Catheterization ; methods ; Cell Line, Tumor ; Disease Models, Animal ; Female ; Hepatic Artery ; Liver Neoplasms, Experimental ; pathology ; Male ; Rabbits ; Radiography, Interventional ; Tomography, Spiral Computed

Obstructive jaundice by vascular compression is rare. The causative arteries were identified as the right hepatic artery, gastroduodenal artery, cystic artery, proper hepatic artery, and an unspecified branch of the common hepatic artery. Also the venous system, such as enlarging collateral veins in cases of portal hypertension was a causative vessel. Herein, we describe a case of a proximal choledocholithiasis due to compression of the common bile duct by right hepatic artery originated from gastroduodenal artery. Final diagnosis and treatment were achieved through an operation.
Cholangiography ; Common Bile Duct/blood supply/*pathology/surgery ; Diagnosis, Differential ; *Hepatic Artery ; Humans ; Jaundice, Obstructive/*diagnosis/etiology/radiography ; Male ; Middle Aged ; Tomography, X-Ray Computed

Hepatocellular carcinoma (HCC) is one of the most frequent primary malignancies in the world, and, particularly, it is common in the Far East. In the world, more than one million new cases of HCC are seen each year. The prognosis of patients with HCC is extremely poor with an average survival of about six months following the diagnosis. In order to improve the prognosis of HCC, early diagnosis should be attempted utilizing mass screening methods. Screening of a high-risk population with alpha-fetoprotein (AFP) along with non-invasive medical imaging modalities will lead to early diagnosis of HCC and subsequent improvement of survival. Indeed, recent advances in medical imaging techniques have increased the rate of detection of small HCCs, and such imaging modalities include ultrasonography(US), radionuclide imaging(RNI), computed tomography(CT), magnetic resonance imaging(MRI), and angiography. Each imaging method is reviewed with special emphasis on the early diagnosis of HCC.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis ; Case Report ; Comparative Study ; False Negative Reactions ; Female ; Hepatic Artery/radiography ; Human ; Liver/pathology/radiography/radionuclide imaging ; Liver Neoplasms/*diagnosis ; Magnetic Resonance Imaging ; Male ; Time Factors ; Tomography, X-Ray Computed ; Ultrasonography

We report the computed tomographic and angiographic findings in the case of a recently obtained successful clinical outcome after embolization of the hepatic artery in the case of a snakebite causing hemoperitoneum associated with hepatic necrosis and rupture with active bleeding.
Aged, 80 and over ; Contrast Media/administration & dosage ; Embolization, Therapeutic/*methods ; Female ; Fibrin Foam/therapeutic use ; Follow-Up Studies ; Hemoglobins ; Hemoperitoneum/*etiology/therapy ; Hemorrhage/etiology/therapy ; Hepatic Artery/radiography ; Humans ; Korea ; Liver/*injuries/pathology/radiography ; Massive Hepatic Necrosis/complications/*etiology/therapy ; Radiographic Image Enhancement/methods ; Rupture, Spontaneous ; Snake Bites/*complications ; Tomography, X-Ray Computed/*methods ; Treatment Outcome ; Viper Venoms/adverse effects

The purpose of this study was to document the additional value of MR imaging during arterial portography (MRAP) in patients examined with intravenous contrast-enhanced dynamic MR imaging for the assessment of focal lesions in patients with cirrhosis or chronic viral hepatitis. The MR images of 24 patients with 39 hepatocellular carcinomas and 18 benign hepatocellular nodules examined with dynamic MR imaging and MRAP within a 14-day interval were retrospectively reviewed. For 39 hepatocellular carcinomas, MRAP revealed 37 perfusion defects (95%), while dynamic MR imaging demonstrated 35 occurrences of nodular contrast-enhancement (90%) on arterial dominant phases. Among the 11 benign nodules misinterpreted as hepatocellular carcinoma due to their high signal intensities on arterial-dominant phases of dynamic MR imaging, eight (73%) showed intratumoral portal venous perfusion on MRAP and were regarded as benign nodules. As a result of its high sensitivity and its potential ability to enable differentiation of benign and malignant hepatocellular nodules, MRAP can be added to dynamic MR imaging for planning future management in patients with equivocal hepatocellular nodules in the cirrhotic liver.
Adult ; Carcinoma, Hepatocellular/diagnosis ; Comparative Study ; Female ; Gadolinium/diagnostic use ; Hepatic Artery/radiography ; Human ; Liver/pathology* ; Liver Cirrhosis/diagnosis* ; Liver Neoplasms/diagnosis ; Magnetic Resonance Imaging/methods* ; Male ; Middle Age ; Portography

An infarction of regenerative nodules in liver cirrhosis is a rare abnormality characterized by their coagulative necrosis. We presume that ischemic necrosis is induced by a sudden reduction in the portal and arterial blood flows after blood loss or shock. Most patients with infarcted regenerative nodules have experienced previous episodes of gastrointestinal hemorrhage. Awareness of the entity of infarcted regenerative nodules and its inclusion in the differential diagnosis of multiple hepatic nodules in liver cirrhosis is important, particularly in patients with an episode of gastrointestinal bleeding. The possible difficulty of differentiating infarcted regenerative nodules in liver cirrhosis from hypovascular hepatocellular carcinoma by initial imaging findings alone means that a liver biopsy and serial imaging might be helpful in the differential diagnosis. We report three cases of multiple infarcted regenerative nodules in liver cirrhosis after gastrointestinal hemorrhage.
Adult ; Diagnosis, Differential ; Esophageal and Gastric Varices/*complications/diagnosis ; Gastrointestinal Hemorrhage/*complications/diagnosis/etiology ; Hepatic Artery ; Humans ; Infarction/*diagnosis/etiology ; Liver/*blood supply/pathology ; Liver Cirrhosis/etiology/*radiography ; Liver Regeneration/physiology ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVETo assess the value of magnetic resonance imaging (MRI) in mid- and long-term complication monitoring after liver transplantation.

METHODSTwenty-one recipients receiving orthotropic liver transplantation between Feb 2003 and May 2005 were enrolled in this study. FLASH T(1)-weighted, T(2)-weighted fast spin echo, T(2)-weighted fat suppression, dynamic gadolinium-enhanced, MR cholangiopancreatography (MRCP) and three-dimensional dynamic gadolinium-enhanced FISP MRA images were obtained.

RESULTSOf the 21 patients, bile duct complications were detected in all cases and liver arterial and venous complications in 8 cases. Liver cancer relapse occurred in 5 cases and allograft failure in 4.

CONCLUSIONMR imaging allows effective monitoring of mid- and long-term complications of liver transplantation, which provides valuable clues for their clinical treatment.

Adult ; Arterial Occlusive Diseases ; diagnosis ; etiology ; Bile Duct Diseases ; diagnosis ; etiology ; Female ; Hepatic Artery ; diagnostic imaging ; pathology ; Humans ; Liver Cirrhosis ; surgery ; Liver Neoplasms ; surgery ; Liver Transplantation ; adverse effects ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Radiography ; Reproducibility of Results ; Sensitivity and Specificity

Bone is a common site of metastasis in patients with hepatocellular carcinoma (HCC). We report a rare case of rib metastasis from HCC treated by transcatheter arterial chemoembolization (TACE). A 55-year-old man with liver cirrhosis presented with right lower chest pain. The diagnosis was an HCC with a bone metastasis in the right eighth rib. Intra-arterial injections of doxorubicin mixed with Lipiodol and Gelfoam particles were instituted through the right eighth intercostal artery. Computed tomography and a Tc99-labeled scan performed 2 months after the third TACE revealed no viable HCC in the right eighth rib.
Bone Neoplasms/radiography/secondary/*therapy ; Carcinoma, Hepatocellular/diagnosis/secondary/*therapy ; *Chemoembolization, Therapeutic ; Doxorubicin/administration & dosage ; Gelatin Sponge, Absorbable/administration & dosage ; Hepatic Artery/pathology ; Humans ; Injections, Intra-Arterial ; Iodized Oil/administration & dosage ; Liver Cirrhosis/diagnosis/pathology ; Liver Neoplasms/diagnosis/pathology/*therapy ; Male ; Middle Aged ; *Ribs/radiography/radionuclide imaging ; Tomography, X-Ray Computed

OBJECTIVE: We assessed the outcomes of a simplified technique for the percutaneous placement of a hepatic artery port-catheter system for chemotherapy infusion in advanced hepatocellular carcinoma with portal vein invasion. MATERIALS AND METHODS: From February 2003 to February 2008, percutaneous hepatic artery port-catheter insertion was performed in 122 patients who had hepatocellular carcinoma with portal vein invasion. The arterial access route was the common femoral artery. The tip of the catheter was wedged into the right gastroepiploic artery without an additional fixation device. A side hole was positioned at the distal common hepatic artery to allow the delivery of chemotherapeutic agents into the hepatic arteries. Coil embolization was performed only to redistribute to the hepatic arteries or to prevent the inadvertent delivery of chemotherapeutic agents into extrahepatic arteries. The port chamber was created at either the supra-inguinal or infra-inguinal region. RESULTS: Technical success was achieved in all patients. Proper positioning of the side hole was checked before each scheduled chemotherapy session by port angiography. Catheter-related complications occurred in 19 patients (16%). Revision was achieved in 15 of 18 patients (83%). CONCLUSION: This simplified method demonstrates excellent technical feasibility, an acceptable range of complications, and is hence recommended for the management of advanced hepatocellular carcinoma with portal vein thrombosis.
Angiography ; Antineoplastic Agents/*administration & dosage ; Carcinoma, Hepatocellular/*drug therapy/pathology ; *Catheters, Indwelling/adverse effects ; Embolization, Therapeutic ; Female ; Femoral Artery/surgery ; Fluoroscopy ; *Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/*drug therapy/pathology ; Male ; Middle Aged ; Portal Vein/*pathology ; *Radiography, Interventional ; Treatment Outcome