Effect of Norepinephrine on Tumor Perfusion: Computed Tomography Angiography Before Tumor Embolization

Abstract

The liver is supplied by two vascular systems: the hepatic artery and the portal vein system. These are connected at the level of the sinusoids. The arterial supply accounts for only 25% of liver blood flow. Malignant tumors and hepatic metastases are supplied by the arterial system only. When embolization of liver tumors is considered, great care must be taken not to destroy residual healthy liver parenchyma. Therefore some groups embolize vessels supplying the tumor selectively. They use special catheter systems and techniques to occlude tumor vessels. This procedure is very time consuming and rather expensive. In a considerable number of cases it is not possible to embolize tumor vessels selectively. Even if the diagnostic work-up shows solitary liver metastasis only, intraarterial injection of Lipiodol frequently discloses multiple metastases.