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AIM:To investigate multidetector CT (MDCT) findings ofhepatocelluar carcinoma (HCC)-associated hepatic arteriovenousshunt (HAYS) and to evaluate their clinical significance.METHODS:Thin-slice and dynamic enhancement MDCT ofHAVS was performed on 56 patients with HCC.MDCTfindings,including those of portal veins,hepatic veins,superior mesenteric veins,splenic veins,HCC foci,liverparenchyma without HCC foci,spleens,and thromboses inportal veins and hepatic veins,were all confirmed by digitalsubtract angiography and analyzed.RESULTS:MDCT demonstrated earlier enhancement ofmain portal trunks and/or the first order branches than thatof superior mesenteric veins or splenic veins (n=31).Onepatient had strong early enhancement of left hepatic veinwith thromboses in left hepatic vein and upper part of inferiorvena cava and 1 patient had transient patchy enhancementperipheral to HCC foci in late hepatic arterial phase amongthem.It demonstrated stronger opacification of main portaltrunks and/or the first order branches than that of superiormesenteric veins or splenic veins (n=18),and earlierenhancement of the second order and smaller branches ofportal veins than that of main portal trunks (n=4),strongeropacification of the second order and smaller branches ofportal veins than that of main portal trunks (n=3),withtransient patchy enhancement (n=3) or wedge-shapedenhancement (n=4) peripheral to HCC foci in late hepaticarterial phase.Enhancement degree of HCC foci was alldecreased.As for 49 patients with severe or moderateshunts,enhancement degree of liver parenchyma withoutHCC foci was increased with heterogeneous density,butenhancement degree of spleens was decreased.There werethromboses in main portal trunks and/or the first orderbranches in 32 patients.CONCLUSION:The main MDCT findings of HCC-associatedHAVS are earlier enhancement and stronger opacification ofportal veins and/or hepatic veins.Understanding of thesefindings will contribute to the diagnosis and prognosis ofthe disease and improve therapy for the patients.
AIM: To investigate multidetector CT (MDCT) findings of hepatocellular carcinoma (HCC) -associated hepatic arteriovenoushunt (HAYS) and to evaluate their clinical significance. METHODS: Thin-slice and dynamic enhancement MDCT of HAVS was performed on 56 patients with HCC. MDCT findings, including those of portal veins, hepatic veins, superior mesenteric veins, splenic veins, HCC foci, liverparenchyma without HCC foci, spleens, and thromboses inportal veins and hepatic veins, were all confirmed by digitalsubtract angiography and analyzed .RESULTS: MDCT prototype earlier enhancement of main portal trunks and / or the first order branches than that of superior mesenteric veins or splenic veins (n = 31). Onepatient had strong early enhancement of left hepatic veinwith thromboses in left hepatic vein and upper part of inferiorvena cava and 1 patient had transient patchy enhancementperipheral to HCC foci in late hepatic arterial phase among them. Ibr stronger thanaccording to main portaltrunks and / or the first order branches than that of superiormesenteric veins or splenic veins (n = 18), and earlierenhancement of the second order and smaller branches ofportal veins than that of main portal trunks (n = 4), strongeropacification of the second order and smaller branches ofportal veins than that of the main portal trunks (n = 3), with transient patchy enhancement (n = 3) or wedge-shape enhancement (n = 4) peripheral to HCC foci in late hepatic artery phase. Enhancement degree of HCC foci was all created. As for 49 patients with severe or moderate shunts, enhancement degree of liver parenchyma without HCC foci was increased with heterogeneous density, butenhancement degree of spleens was decreased. There were thromboses in main portal trunks and / or the first order branches in 32 patients. CONCLUSION: The main MDCT findings of HCC- associatedHAVS are earlier enhancement and stronger opacification of portal veins and / or hepatic veins. Understanding of these findings will contribute to the diagnosis and prognosis of the ddisease and improve therapy for the patients.