Imaging diagnosis of ruptured site in hepatocellular carcinoma

Rupture causes frequently the patients with HCC to death. Then it is important to investigate ruptured site of HCC in order to stop bleeding effectively and safely by emergent TAE without causing liver failure. We evaluate the usefulness of 3 major imaging methods, such as US, CT and angiography in our 18 cases of HCC. In ultrasonography, ruptured site was shown as the high echoic area localized around the tumor in 4/15 cases (26.7%). In computed tomography of rapid scanning, it was shown as the intraperitoneal high density area around the tumor in 3/18 cases (16.7%). And lipiodol CT showed the characteristic leakage in the abdominal cavity. In angiography, it was shown as the extravasation of contrast material only in 2/13 cases (15.4%). In the results, it was possible to diagnose the ruptured site in 8/18 cases (44.4%) by using these procedures. Diagnosis of ruptured site will make it possible to reduce the frequency of hepatic failure caused by emergent TAE. (author)