Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC
Abstract Background Transarterial chemoembolization (TACE) is considered a standard local-regional treatment for intermediate-stage hepatocellular carcinoma (HCC) and the most common bridging therapy. HCC typically receives its blood supply from the hepatic artery; however, it can recruit a parasiti...
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doaj-dc3f3a9ac0df459d8ff73e8726debcf92020-11-25T02:56:42ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622020-03-0151111210.1186/s43055-020-00167-5Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCCMohamed Saied Abdelgawad0Rasha Abdelhafiz Aly1Radiology Department, National Liver Institute, Menoufia UniversityRadiology Department, National Liver Institute, Menoufia UniversityAbstract Background Transarterial chemoembolization (TACE) is considered a standard local-regional treatment for intermediate-stage hepatocellular carcinoma (HCC) and the most common bridging therapy. HCC typically receives its blood supply from the hepatic artery; however, it can recruit a parasitic supply from extrahepatic collateral arteries. The right inferior phrenic artery (RIPA) is considered the most common extrahepatic collateral pathway supplying HCC and so interfere with the therapeutic efficacy of TACE resulting in treatment failure and poor outcome. Imaging by MDCT with angiography has an essential role in depicting the presence or absence of an EHC arterial supply during the pre-TACE evaluation. We analyzed MDCT studies with CT angiography of patients with hepatic dome HCC retrospectively to confirm the diagnosis of HCC and to assess its blood supply. All patients were subjected to a proper assessment by history, clinical examination, as well as routine laboratory investigations Results Our study includes 58 cases with hepatic dome HCC. On CT angiography, the extrahepatic collateral from the RIPA supplying hepatic dome HCC was detected in about 33 out of 58 cases (56.9%). The RIPA arose directly from the aorta in 30 cases (90.9%) with only three cases (9.1%) from the celiac trunk. All cases were managed with TACE with about 25 out of 33 cases (75.8%) with extrahepatic RIPA were undergone concomitant embolisation of both RIPA and hepatic artery during TACE procedure. Conclusion MDCT assesses well the HCC arterial supply which is fundamental for planning subsequent cannulation and embolization of extrahepatic RIPA supply to hepatic dome HCC.http://link.springer.com/article/10.1186/s43055-020-00167-5Hepatic domeHCCMDCTRIPAChemoembolization |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mohamed Saied Abdelgawad Rasha Abdelhafiz Aly |
spellingShingle |
Mohamed Saied Abdelgawad Rasha Abdelhafiz Aly Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC The Egyptian Journal of Radiology and Nuclear Medicine Hepatic dome HCC MDCT RIPA Chemoembolization |
author_facet |
Mohamed Saied Abdelgawad Rasha Abdelhafiz Aly |
author_sort |
Mohamed Saied Abdelgawad |
title |
Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC |
title_short |
Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC |
title_full |
Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC |
title_fullStr |
Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC |
title_full_unstemmed |
Right inferior phrenic artery; Don't miss on MDCT before chemoembolization of hepatic dome HCC |
title_sort |
right inferior phrenic artery; don't miss on mdct before chemoembolization of hepatic dome hcc |
publisher |
SpringerOpen |
series |
The Egyptian Journal of Radiology and Nuclear Medicine |
issn |
2090-4762 |
publishDate |
2020-03-01 |
description |
Abstract Background Transarterial chemoembolization (TACE) is considered a standard local-regional treatment for intermediate-stage hepatocellular carcinoma (HCC) and the most common bridging therapy. HCC typically receives its blood supply from the hepatic artery; however, it can recruit a parasitic supply from extrahepatic collateral arteries. The right inferior phrenic artery (RIPA) is considered the most common extrahepatic collateral pathway supplying HCC and so interfere with the therapeutic efficacy of TACE resulting in treatment failure and poor outcome. Imaging by MDCT with angiography has an essential role in depicting the presence or absence of an EHC arterial supply during the pre-TACE evaluation. We analyzed MDCT studies with CT angiography of patients with hepatic dome HCC retrospectively to confirm the diagnosis of HCC and to assess its blood supply. All patients were subjected to a proper assessment by history, clinical examination, as well as routine laboratory investigations Results Our study includes 58 cases with hepatic dome HCC. On CT angiography, the extrahepatic collateral from the RIPA supplying hepatic dome HCC was detected in about 33 out of 58 cases (56.9%). The RIPA arose directly from the aorta in 30 cases (90.9%) with only three cases (9.1%) from the celiac trunk. All cases were managed with TACE with about 25 out of 33 cases (75.8%) with extrahepatic RIPA were undergone concomitant embolisation of both RIPA and hepatic artery during TACE procedure. Conclusion MDCT assesses well the HCC arterial supply which is fundamental for planning subsequent cannulation and embolization of extrahepatic RIPA supply to hepatic dome HCC. |
topic |
Hepatic dome HCC MDCT RIPA Chemoembolization |
url |
http://link.springer.com/article/10.1186/s43055-020-00167-5 |
work_keys_str_mv |
AT mohamedsaiedabdelgawad rightinferiorphrenicarterydontmissonmdctbeforechemoembolizationofhepaticdomehcc AT rashaabdelhafizaly rightinferiorphrenicarterydontmissonmdctbeforechemoembolizationofhepaticdomehcc |
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