Diagnosis

Hepatocellular cancer, treated by chemoembolization.

Findings

Pretreatment MPR CT images (first and second images) demonstrate a hypervascular mass in the right lobe of the liver, supplied by hypertrophied branches of the right hepatic artery. The coronal 3D CT image (third image) clearly defines this arterial anatomy, again showing hypertrophied arteries supplying the inferior right hepatic mass. Findings are consistent with the given history of hepatocellular carcinoma. The coronal 3D dual phase image (fourth image) again shows the arterial anatomy, but also shows patency of the main portal veins.

Posttreatment MPR CT images (fifth image) demonstrate high attenuation material concentrated in the inferior right lobe of the liver, in the location of the hepatocellular carcinoma. Findings represent expected findings of intraarterial chemotherapy administration following selective right hepatic artery catheterization.

Discussion

Advances in CT imaging have allowed improved visualization of the tumor size and vascular supply. These advanced techniques can also help to plan the optimum vascular approach to deliver the embolic material. The 3D volume image in this case is especially helpful for visualizing tortuous or complex vascular supplies to the tumor and the area of liver tissue supplied by each vessel.