European Radiology

, Volume 27, Issue 6, pp 2474–2481 | Cite as

Haemodynamic changes in hepatocellular carcinoma and liver parenchyma under balloon occlusion of the hepatic artery

  • Fumie Sugihara
  • Satoru Murata
  • Tatsuo Ueda
  • Daisuke Yasui
  • Hidenori Yamaguchi
  • Izumi Miki
  • Chiaki Kawamoto
  • Eiji Uchida
  • Shin-ichiro Kumita



To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion.


Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver.


In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group.


Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion.

Key Points

Hepatic artery occlusion causes haemodynamic changes in hepatocellular carcinoma and liver.

Segmental occlusion decreased rate of change in hepatocellular carcinoma-to-liver attenuation ratio.

Subsegmental occlusion increased rate of change in hepatocellular carcinoma-to-liver attenuation ratio.

Hepatic artery occlusion decreased enhancement volume of hepatocellular carcinoma and liver.

Hepatic artery occlusion causes perfusion defects in hepatocellular carcinoma.


Balloon occlusion Therapeutic chemoembolization Hepatocellular carcinoma Haemodynamics Multidetector computed tomography 



Balloon-occluded transarterial chemoembolization


Computed tomography


Computed tomography hepatic arteriography


Hepatocellular carcinoma


Hepatocellular carcinoma to liver parenchyma attenuation ratio


Hounsfield units


Transarterial chemoembolization



The scientific guarantor of this publication is Satoru Murata. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all patients in this study. None of the study subjects or cohorts have been previously reported. Methodology: prospective, observational, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Fumie Sugihara
    • 1
  • Satoru Murata
    • 1
  • Tatsuo Ueda
    • 1
  • Daisuke Yasui
    • 1
  • Hidenori Yamaguchi
    • 1
  • Izumi Miki
    • 1
  • Chiaki Kawamoto
    • 2
  • Eiji Uchida
    • 3
  • Shin-ichiro Kumita
    • 1
  1. 1.Department of Radiology, Center for Advanced Medical TechnologyNippon Medical SchoolTokyoJapan
  2. 2.Department of Internal MedicineNippon Medical SchoolTokyoJapan
  3. 3.Department of SurgeryNippon Medical SchoolTokyoJapan

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