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Injection of iodized oil (Lipiodol) into the hepatic artery is widely used in the diagnosis and treatment of hepatocellular carcinoma. However, no reports have yet appeared concerning temporal changes in hepatic metabolism following Lipiodol injection. In the present study, Lipiodol was injected into the hepatic arteries of normal and cirrhotic rats, successive P-31 MR measurements were performed, and temporal changes in metabolism were compared with histologic findings. Both normal and cirrhotic rats displayed minimum levels of beta-ATP/PME and beta-ATP/Pi 5 days after hepatic arterial injection of Lipiodol. However, 10 days after injection these values had reverted to the preinjection levels. The metabolic dysfunction observed in the liver following hepatic arterial injection of 0.3 ml/kg b.w. Lipiodol was transient. Moreover, no distinct differences were observed between P-31 MR changes in normal and cirrhotic rats. Conversely, histologic impairment assessed on the basis of hepatic necrosis ratios was most severe 2 days after hepatic arterial injection in both normal and cirrhotic rats, and this did not coincide with the time of the most pronounced metabolic impairment as inferred from P-31 MR changes.

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Enhancement of liver cancer on ultrasonography (US) by injection of new contrast medium (LEVOVIST) was performed in rats with 3'-methyl-4-dimethylaminoazobenzene-induced hepatic carcinoma. Echosignals of cancer nodules increased remarkably after the intrahepatic arterial injection of LEVOVIST (200, 300 mg/ml), and contrast enhancement was observed for at least 15 minutes. Furthermore, US after the intrahepatic arterial injection of LEVOVIST (200 mg/ml) can visualize small nodule, which was not recognizable on plain US. As a result of increased echosignals of normal liver parenchyma after the intra-portal injection of LEVOVIST (300 mg/ml), the cancer nodules were demonstrated as hypoechoic. These results indicate that this new contrast medium for sonography is effective in the diagnosis of liver cancer.

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Iodized oil (Lipiodol) has been used for the diagnosis and treatment of hepatic malignancies, especially that of hepatocellular carcinoma. However, few reports have appeared concerning intrahepatic microvascular changes following intrahepatic arterial injection of Lipiodol. In the present study, Lipiodol was injected into the hepatic arteries of normal and cirrhotic rats, the changes of intrahepatic microvascular structures were serially investigated by scanning electron microscopy of microvasculature casts. In normal rats following intrahepatic arterial injection of Lipiodol, impairments of capillary vessels in the peribiliary plexus (PBP) were noted. The degrees of PBP impairments were most severe 2 days after the injection of Lipiodol. However, 10 days after the injection of Lipiodol, these impairments had almost completely vanished. There was no changes of terminal arterial and portal branches. In cirrhotic rats, proliferations of the perinodular arterial plexus (PNAP) and dilatations of the PBP were noted. After intrahepatic arterial injection of Lipiodol, the impairments of the PBP were noted, as in the normal rats. However, the degrees of these impairments were milder than those in the normal rats. It was considered that the decrease of the PBP impairments caused by Lipiodol were influenced by proliferation of the PNAP and dilatations of the PBP in cirrhotic rats. After intrahepatic arterial injection of Lipiodol in normal and cirrhotic rats, there was no development of collateral vessels. It was believed, therefore, that this fact was an advantage in the treatment of hepatic carcinoma by Lipiodol.

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The patient is a 33-year-old female. On precontrast CT, the tumor shows a high density area with a low density area. On postcontrast CT, the tumor demonstrates a well-marginated low density area. Angiographically, the tumor shows a hypervascular mass with tumor vessels like a weeping willow and unhomogeneous stain. This is only the fourth such case ever reported before in Japan.

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The serial histological changes of the liver following the intrahepatic arterial injection of Lipiodol in the rat with cirrhosis were investigated. The hepatocytes showed acidophilic degeneration and focal necrosis after 12 hours and restoration of focal necrosis was seen after 72 hours. Necrosis and infarction were resolved after 120 hours. We concluded that the intrahepatic arterial injection of 0.1 ml Lipiodol in the rat with cirrhosis was safely performed.

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The patient, a 45-year-old male, complained of left flank pain and fever. CT revealed bilateral adrenal tumors, in which MRI disclosed inhomogeneous signal intensity with low signal intensity rim. Arteriography demonstrated bilateral adrenal tumors with moderately rich tumor vessels.

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