HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kim, H.-C. Articles by Park, J. H. Search for Related Content PubMed PubMed Citation Articles by Kim, H.-C. Articles by Park, J. H. Related Collections Gastrointestinal Radiology Vascular and/or Interventional Radiology

Recognizing Extrahepatic Collateral Vessels That Supply Hepatocellular Carcinoma to Avoid Complications of Transcatheter Arterial Chemoembolization¹

¹ From the Department of Radiology, Seoul National University College of Medicine, and the Institute of Radiation Medicine, Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. Recipient of a Cum Laude award for an education exhibit at the 2004 RSNA Annual Meeting. Received February 8, 2005; accepted March 23. All authors have no financial relationships to disclose. Address correspondence to J.W.C. (e-mail: chungjw{at}radcom.snu.ac.kr).

Extrahepatic collateral arteries commonly supply hepatocellular carcinomas if the tumors are large or peripherally located. Because development of these vessels interferes with effective control of the tumor with transcatheter arterial chemoembolization (TACE), radiologists should become familiar with the imaging findings of extrahepatic collateral vessels to detect them at an early stage. The authors observed 2104 such vessels in 860 patients over 5.5 years. The extrahepatic collateral vessels observed originated from the inferior phrenic artery, omental branch, adrenal artery, intercostal artery, cystic artery, internal mammary artery, renal or renal capsular artery, branch of the superior mesenteric artery, gastric artery, and lumbar artery. The authors suspected extrahepatic collateral vessels when (a) a tumor grew exophytically or invaded adjacent organs, (b) a tumor was in contact with the ligaments and bare area of the liver, (c) a hypertrophied extrahepatic collateral vessel was observed on a computed tomographic (CT) scan, (d) a peripheral defect of iodized oil retention within a tumor was seen during chemoembolization or on a follow-up CT scan, (e) a local recurrence developed at the peripheral portion of the treated tumor during follow-up, or (f) a sustained elevation in serum -fetoprotein level was noted despite adequate embolization of the hepatic artery. When both the hepatic artery and extrahepatic collateral vessels supply a tumor, additional extrahepatic collateral vessel chemoembolization should be attempted to increase the therapeutic efficacy of TACE for hepatocellular carcinoma.

This article has been cited by other articles:

				D. I. Gwon, G.-Y. Ko, H.-K. Yoon, K.-B. Sung, J. M. Lee, S. J. Ryu, M. H. Seo, J.-C. Shim, G. J. Lee, and H. K. Kim Inferior Phrenic Artery: Anatomy, Variations, Pathologic Conditions, and Interventional Management RadioGraphics, May 1, 2007; 27(3): 687 - 705. [Abstract] [Full Text] [PDF]

				H.-C. Kim, J. W. Chung, S. H. Choi, H. J. Jae, W. Lee, and J. H. Park Internal Mammary Arteries Supplying Hepatocellular Carcinoma: Vascular Anatomy at Digital Subtraction Angiography in 97 Patients Radiology, March 1, 2007; 242(3): 925 - 932. [Abstract] [Full Text] [PDF]