We present a technique used to avoid unnecessary embolization of the cystic artery in the treatment of hepatoma by transcatheter arterial embolization. A special long tapering catheter that is flexible and soft enough to be inserted into the distal small branches of the heptic artery is used. Embolic material ( Oxycel , absorbable cellulose) was mixed with Mitocin -C (mitomycin) and contrast material. This mixture will help to avoid reflux.

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Two cases of a three-year-old boy with retroperitoneal ganglioneuroblastoma and a sixteen-year-old boy with mediastinal ganglioneuroma correctly diagnosed by

Serial changes in sonographic appearance after transcatheter hepatic arterial embolization (TAE) were studied in 22 patients who had hepatoma and one patient who had a hepatoblastoma. These changes were classified into three types. In cases of type 1, the internal echo of the entire tumor became remarkably echogenic with or without an acoustic shadow. In cases of type 2, echogenic areas or scattered echogenic spots with or without acoustic shadows were observed. In Type 3 cases, no changes in sonographic appearance were observed. Tumor diameters in all of the type 1 cases were less than 4.9 cm. Various size tumors were observed in the cases of type 2 and type 3. Transcatheter arterial embolization was completely effective or effective in 89 per cent of the type 1 and type 2 cases, but was not effective in 75 per cent of the type 3 cases. The sonographic changes correlated well with the effectiveness of TAE.

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The ultrasonographic appearance of hepatic hemangiomas was studied in 19 patients (31 lesions). The detectability rate by real-time ultrasonography was 77%. A hyperechoic, sharply-marginated and internally homogeneous lesion is highly suggestive of hemangioma. If the hypoechoic lesion has homogeneous internal echoes and/or strong marginal echoes, it is also suggestive of hemangioma. It is difficult to detect small lesions in the lower lateral part of the right lobe and lesions in the right lobe immediately under the diaphragm. Computed tomography should be the next procedure of choice in the evaluation process. If the computed tomography is not characteristic, angiography should be done to confirm the diagnosis.