Intraductal Papillary Mucinous Neoplasm with Associated Invasive Carcinoma Arising from Remnant Cystic Duct: A Case Report

Intraductal papillary mucinous neoplasm (IPMN) involving the biliary system is rare. To date, only a few cases of IPMN arising from the extrahepatic bile duct have been reported. In our case, extrahepatic IPMN arose in the remnant cystic duct after cholecystectomy, and to the best of our knowledge, this is the first report in the remnant cystic duct after cholecystectomy. A 74-year-old woman was referred for right upper quadrant pain lasting one day. Ultrasonography (US) showed a lobulated and hyperechoic mass with an outer linear hypoechoic lesion located adjacent to the dilated common bile duct. Contrast enhanced computed tomography showed a heterogeneously enhancing mass. Magnetic resonance imaging (MRI) showed a heterogenous mass with an outer semicircular high signal portion indicating remnant cystic duct.

Primary Hepatic Amyloidosis: Report of an Unusual Case Presenting as a Mass

Hepatic involvement of amyloidosis is common. Diffuse infiltration with hepatomegaly is a usual radiologic finding of hepatic amyloidosis. To our knowledge, this is the first case of amyloidosis involving the liver that presented as a mass.

Dynamic CT Finding of Pelioid HCC; Case Report / 영남의대학술지

Pelioid hepatocellular carcinoma (HCC), a type of atypical HCC, is a rare histologic type of HCC. The radiologic findings of the pelioid HCC is differ from the typical type of HCC. To our knowledge, this case report is the second literature to show the enhancing features of a pelioid HCC on dynamic computed tomography (CT). Here we describe the dynamic CT findings in a case of surgically confirmed pelioid HCC.

Prognosis and Treatment Outcomes of Gastric Cancer Patients with Hepatic Metastasis

PURPOSE: This study was conducted to evaluate the treatment outcomes and the prognosis for gastric cancer patients with hepatic metastasis. MATERIALS AND METHODS: This retrospective study was based on the medical records of 85 gastric cancer patients with hepatic metastasis (62 synchronous and, 23 metachronous) who received chemotherapy with or without resectional therapy from March 1990 to March 2006. The survival rate was analyzed according to clinicopathologic factors and therapeutic factors, such as whether or not a gastrectomy, a hepatic resection, and/or chemotherapy had been performed. RESULTS: The median survival of gastric cancer patients with hepatic metastasis was 11 months (synchronous: 11 months and metachronous: 17 months). The rates of gastrectomies and hepatic resections in the synchronous group were 24.1% and 16.1%, respectively. A 23.5% prevalence of extra-hepatic metastasis was observed. The median survivals of patients who underwent a gastrectomy with a hepatic resection, a gastrectomy alone, and non-surgical treatment were 60, 18, and 9 months, respectively (P<0.05). The disease-free median survival of the metachronous group was 8 (3~39) months. There was no difference in initial pathologic stage and frequency of hepatic metastasis after the gastrectomy in the metachronous group. In the synchronous group, extra-hepatic metastasis, a gastrectomy as the operative procedure, a hepatic resection as the operative procedure and the response to chemotherapy were statistically significant in the univariate analysis, and a hepatic resection as the operative procedure, the response to chemotherapy, and extra-hepatic metastasis were independant prognostic factors identified by the multivariate analysis. In the metachronous group, extra-hepatic metastasis, the response to chemotherapy and differentiation were statistically significant in the univariate analysis, and extra-hepatic metastasis was an independent prognostic factor identified by the multivariate analysis. CONCLUSION: An aggressive surgical therapy and effective chemotherapy are necessary in the treatment of gastric cancer patients with hepatic metastasis.

Imaging Feature of Radiation Induced Lung Disease / 영남의대학술지

BACKGROUND AND PURPOSE: Radioopaque lesions are commonly seen in patients who received thoracic radiotherapy for various kinds of thoracic neoplasm, But therir exact diagnos are sometimes uncertain. PATIENTS AND METHODS: We examined simple chest radiograph and computed tomogram(CT) of 69 patients who received thoracic radiotherapy for lung cancer and were follow up at least 6 months in Yeungnam University Medical Center. RESULTS: Of the 69 patients. thirty-eight patients showed radioopaque lesions in their chest radiographs except radiation fibrosis; radiation pneumonitis was witnessed in 24 patients. infectious pneumonia in 8 patients, and recurrence in 6 patients. In radiateionpneumonitis patients, the pneumonitis occurred usually between 50 to 130 days after receiving radiation therapy, and interval between pneumonitis and fibrosis is 21 to 104 days. Simple chest radiographs of radiation pneumonitis(24 patients) represented ground glass opacities or consolidation in 4 cases(type I, 17%), reticular of reticulonodular opacities in 10 cases(type II, 42%), irregular patichy consolidations in 2 cases( type III, 8%), and consolidation with fibrosis in 8 cases(type IV, 33%), CT represent ground glass opacities or consolidation in 5 cases(type I, 29%), irregular nodular opacities in 3 cases(type II, 19%), irregular opacity beyond radiation fields in 3 cases(type III, 18%), and consolidation with fibrosis in 6 cased(typeIV, 35%). The CT of four patients who represented type II on simple chest radiographs reveal type I and III, and CT of two patients with clinical symptoms who had no abnormal finding on simple radiograph revealed type I. CONCLUSIONS: In conclusion, computed tomogram is superior to the simple radiograph when trying to understand the pathologic process of radiation pneumonitis and provide confidence in the diagnosis of radiation induced lung disease.

Primary Hepatic Leiomyosarcoma: A case report

The liver is a distinctly unusual locus for a primary leiomyosarcoma. In October 1994, a 64-year-old female patient was admitted with palpable mass at the right upper abdomen for 2 months. Ultrasonography and Computed Tomography revealed a big cystic nature tumor at the right lobe of the liver. A right lobectomy was undertaken. On gross examination of the specimen, the tumor size was measured a 7.5 cm 16.0 cm 4.5 cm. On a cut section, cystic degeneration was showed and the color of the solid component was grayish. Microscopic examination growth pattern of the tumor to be expansive with no capsule. Finally the leiomyosarcoma of the liver was diagnosed with 5 to 6 mitosis per 10 high power fields. In September 1995, follow-up Computed Tomography revealed a recurred mass on segment 4 of the liver. A tumonectomy was performed. Twenty-one months after the second operation, recurrence was noted on the remaining liver and intraabdomen. Debulking surgery of the intraabdominal mass with intraperitoneal chemotherapy was undertaken. We report this case of primary hepatic leiomyosarcoma with a review of the literatures.

Percutaneous Nephrostomy Using 18 Guage Puncture Needle / 영남의대학술지

Percutaneous nephrostomy was performed using 18 guage pucture needle under ultrasonic guidance in 58 patients, 98 cases with hydronephrosis (bilateral; 15 cases, repeat nephrostomy; 25 cases). The causes of the hydronephrosis were malignancy(33 patients, 65 cases), benign diseases(18 patients, 25 cases), and unknown causes(seven patients, eight cases). Successful nephrostomy was achieved in all cases. Major complication was not found, but seven(7.1%) minor complications, such as gross hematuria(four cases), perirenal urine leakage(two cases), and fever(one cases) were developed. The complication rate in our study was similar to that of other studies using 21 guage puncture needle. In conclusion, we think that the percutaneous nephrostomy using 18 guage puncture needle is a simple, safe, and cost and time effective procedure and it can replace the method using 21 guage puncture needle.

Pitfalls of Tc-99m RBC SPECT in Diagnosis of Hepatic Hemangioma: Correlation with Enhancing Pattern on Two-phase Dynamic CT

PURPOSE: To elucidate the pitfalls of Tc-99m RBC liver SPECT in the diagnosis of hepatic hemangioma, and to compare this modality with two-phase dynmic CT. MATERIALS AND METHODS: Forty patients with 48 liver masses, suspected on ultrasonography to be hemangiomas, underwent two-phase dynamic CT scanning and SPECT within a two week period. All masses were diagnosed through pathologic and follow up radiologic studies. The final diagnoses were hemangioma (n=42), metastasis (n=2), abscess (n=2), hepatocellular carcinoma (n=1), and cholangiocarcinoma (n=1). Sensitivities and specificities of CT and Spect for the diagnosis of hemangioma and the relationship between false positives or false negatives seen on SPECT and the Pattern of contrast enhancement seen on CT were investigated. RESULTS: The sensitivities of CT and SPECT for the diagnosis of hemangioma were 95.2 (40/42) and 76.2% (32/42), respectively. The false-negative rate of SPECT was significantly higher in the early enhancing (54.5%, 6/11) than in the late enhancing type (13.8%, 4/29) and in the 'less than 1cm' group, false-negatives (70%, 7/10) were more common than in the 'more than 1cm' group (9.4%, 3/32). for the two lesions with false-positive findings on SPECT, the final diagnosis was metastasis, and two false-negative lesion, seen on CT, were misread as metastases. Four other lesions were negative in both studies. CONCLUSION: For the detection of hepatic hemangioma, two-phase dynamic CT is a better modality than SPECT. False positives on SPECT occurred in metastasis, and false negatives are more common in the small lesion and early enhancing group than in the late enhancing group. Between the two groups, there is a difference in hemodynamics, and considerable further pathological investigation is needed.

Correlation of Elevated Tumor Markers and Hepatic and Nodal Metastases on CT in Postgastrectomy Patients for Gastric Cancer

PURPOSE: The evaluation of tumor recurrence or metastasis in postgastrectomy cancer patients usually depends on a serum tumor marker test or radiologic study, but in both cases, accuracy is difficult to determine. The purpose of this study was to evaluate the relationship between abdominal CT and serum tumor markers. MATERIALS AND METHODS: In 337 cases involving 226 patients who had undergone curative surgery for gastric cancer, we compared serum tumor markers and CT for the evaluation of metastasis. Among these 337 cases, CEA level was measured in 317, CA 19-9 level in 166, and both of these in 146. The cutoff level for serum carcinoembryonic antigen (CEA) and CA19-9 were 10 ng/ml and 33 U/ml, respectively. RESULTS: CEA level was elevated in 59 of 317 cases (18.6 %) and that of CA 19-9 in 58 of 166 (34.9 %). Slightly higher overall senstivity and specificity was observed for CEA than for CA 19-9 (72.9 % vs 67.2 %, 83.3 % vs 70.4 %, respectively). Among the total of 337 cases, liver or lymph node metastases were detected in 91 cases (27.0 %) on CT. Negative predictive value was significantly higher in CEA than in CA 19-9 (93.1 % vs 80 %, respectively) (p < 0.01), but positive predictive value was lower (50 % vs 54.9 %, respectively). On CT scan, there was a significant relationship between serum tumor marker level and hepatic and nodal metastasis ; specificity and positivity of serum tumor markers were both higher than sensitivity and negativity. CONCLUSION: Follow-up CT less useful when tumor markers levels are not elevated, but when these are elevated in postgastrectomy cancer patients, meticulous radiologic evaluation is necessary for the early detection of residual or recurrent tumors.

Dynamic CT Findings of Eosinophilic Hepatic Abscess and Its Clinical Course

PURPOSE: To evaluate dynamic CT features and its clinical courses of eosinophilic hepatic abscess. MATERIALS AND METHODS: Two-phase dynamic CT findings and the clinical courses of 13 pathologically proven cases of eosinophilic abscess were reviewed. All patients showed peripheral eosinophilia, and diagnoses were confirmed by ultrasound-guided biopsy(n=9) or operation(n=4). In two of the four patients who underwent segmental hepatectomy, worms of the species Fasciola hepatica were detected. Follow-up CT scans after treatment with antibiotics or praziquantel were available in seven and eight patients, respectively. RESULT: All hepatic lesions were found ina subcapsular location or in contact with Glisson's capsule around the bile duct. Arterial-dominant phase CT(n=11)demonstrated clusters of ill-defined low density masses without rim enhancement. Late-phase CT(n=13) more clearly depicted clustering lesions with enhancing rims and diminution of the low-density area. Follow-up CT scans aftertreatment with antibiotics(n=7) showed no change in the lesions in three patients and slight shrinkage of the mainmass with additional new lesions in four. On CT scans of nine patients performad after praziquantel therapy, hepatic masses were seen in all patients to be very slightly smaller after improvement of peripheral hypereosinophilia. CONCLUSION: Two-phase dynamic CT features appear to be helpful for the diagnosis ofeosinophilic hepatic abscess in patients with peripheral eosinophilia. Parasitic infestation by Fasciola hepaticafor example, is the presumed cause of such abscesses, though further studies are required.

Anatomical variation of the Main and Right Portal Vein on Indirect Portogram: Correlated with CT and Hepatic Angiogram

PURPOSE: To describe variations of the main and right portal veins as visualized by indirect portograms and to examine the surgical implications of these findings. MATERIALS AND METHODS: A retrospective review was conducted of 632 indirect portograms of 632 patients in whom third-order branches were visualized. All patientsalso underwent dynamic CT and AP and oblique hepatic angiography. RESULTS: Variations of the main portal veinwere found in 165 patients(26.1%) and involved an immediate trifurcation of the main portal vein in 102 patients(16.1%), early division of the right posterior portal vein in 53(8.4%), simultaneous division into fourbranches in three (0.5%), five branches in two (0.3%), a replaced P4 originating from the right portal vein in two(0.3%), and an accessory P6 originating from the main portal vein, a replaced P6 originating from the main portalvein, or a replaced left lateral portal vein originating from the right portal vein in one (0.2%), respectively.Of 468 patients who had a common right portal vein, absence of the right posterior portal vein was seen in 26 patients(5.6%) and an accessory subsegmental branch originating from the right portal vein in 17 patients(3.6%). CONCLUSIONS: Recognition of such variations of the portal vein assists in the localization and appreciation ofthe hepatic segmental anatomy, in preoperative evaluations for hepatic resections, and in radiologic interventional procedures through the portal vein.

Primary Hepatic Leiomyosarcoma: A Case Report

Primary hepatic leiomyosarcoma is an extremely rare neoplasm, with fewer than 60 previously reported cases. Apatient was admitted with pain and palpable mass in the right upper abdomen. An ultrasonogram showed a largecystic mass with irregular thick wall in the right lobe of the liver. On a CT scan, the mass showed irregular enhancement along its wall, but central portion was not enhanced. A celiac angiogram revealed a large hypervascular mass with abundant abnormal vascularities in its peripheral portion. Right hepatectomy was undertaken, and histologic examination, revealed hepatic leiomyosarcoma.

Significance of the AFP Level and HBsAg in Differentiation of Hepatic Masses / 영남의대학술지

Hepatic masses show different enhancing patterns in N bolus computed tomography: Hepatocellular carcinoma shows high-attenuation in the early enhancing phase and low-attenuation in the late enhancing phase, hemangioma shows peripheral dot-like high-attenuation in the early enhancing phase and central high-attenuation in the late enhancing phase, and metastatic cancer and cholangiocelluar carcinoma show peripheral high-attenuation rim in the early enhancing phase and central portion gradulally high attenuation in the late enhancing phase. but sometimes enhancing patterns of the hepatic masses are confuse. To evaluate the significance of the AFP level and HBsAg in differentiation of the hepatic masses, we retrospectively analyzed AFP level and HBsAg' in 228 pathologically or radiologically confirmed hepatocellular carcinomas, and 137 pathologically nonhepatocellular cacinomas. The results were as follows In hepatocellular carcinoma, AFP level above 20ng/ml was 77.8% and HBsAg positve was 72.6%. In nonhepatocellular carcinoma, AFP level above 20ng/ml was 3.7% and HBsAg positve was 16.1%. We concluded that AFP level and HBsAg are helpful to distinguish hepatocellular carcinoma from nonhepatocellular carcinoma, when IV bolus computed tomogram finding is uncertain.

Radiologic Characteristics of Hepatocellular Carcinoma with Intrabile Duct Tumor Growth and Extension

PURPOSE: To determine the radiologic characteristics of the hepatocellular carcinoma with intrabile ducttumor growth and extension. MATERIALS AND METHODS: We analyzed the arterial-dominant phase(ADP) CT scans, hepaticangiograms and cholangiograms in nine cases of hepatocellular carcinomas with intrabile duct tumor growth andextension confirmed by tumor thrombectomy. RESULTS: The gross types were nodular in three cases and massive infive. Two masses were larger than 6cm, four were between 3 and 6cm, and three were less than 3cm. Among six casesof ADP-CT scan, dense contrast enhancement was observed in four, minimal enhancement in one, and no enhancement inone. In one case we were unable to find a primary mass. With regard to tumor staining on hepatic arteriograms, five cases were hypervascular, one case was hypovascular, and the remaing one was not found. All tumor thrombi were seen as filling defects which were dilating the bile duct on cholangiograms. Among five intrabile ducttumors, thrombi were detected on ADP-CT scan(n=6), dense contrast enhancement was observed in one case, minimalenhancement in two cases and no enhancement in two cases. CONCLUSION: Intrabile duct tumor growth and extensionin hepatocellular carcinoma(HCC) does not correlate with location, mass size or tumor vascularity. It was concluded that tumor thrombi were formed through the direct invasion by a tumor of a branch of the intrahepaticduct, its growth in the distal direction in the biliary tree and subsequent extension to the common bile duct. Thrombi were more hypovascular than primary mass.

Patterns of Recurrence after Curative Resection of Hepatocellular Carcinoma: Radiological Type

PURPOSE: To obtain the useful information about tumor behavior of hepatocellular carcinoma by analyzing the recurrence pattern after curative resection. MATERIALS AND METHODS: Forty-two patients who underwent curative resection of hepatocellular carcinoma were analyzed. Based on the firstly detected radiologic recurrence, we classified recurrence patterns into three types, type I;marginal recurrence, type II;intrahepatic nodular(multiple, single) and type III;extrahepatic. We also analyzed its duration of recurrence after curative resection. RESULTS: Eighteen patients showed no radiologic recurrence during follow-up period(mean 19.2 months). Twenty-four patients showed radiologic recurrence at 29 sites and its mean duration was 11.0 months. Recurrence patterns were seven cases in type I, 14 cases in type II(multiple 11, single three), eight cases in type III including two omental, two extrahepatic lymph node, two brain, one spine, and one intracranial metastasis. Among the extrahepatic recurrences, five cases showed only distant metastasis without hepatic recurrence. Mean duration of recurrence according to the site was 16.0 months in type I, 12.6 months in type II, 12.3 months in type III. Among 20 patients with single site recurrence, type 11(9.0 months) was earlier than type 1(10.3 months). CONCLUSION: lntrahepatic recurrence is more common than extrahepatic recurrence. Intrahepatic nodular, especially multinodular recurrence, is more common than marginal recurrence. Intrahepatic recurrence has tendency to develope earlier metastain earlier than marginal recurrence.

Nodular Lesions Seen on CTAP Not on Conventional CT in Known Hepatocellular Carcinoma(HCC) Patients: Positive Predictive Value for HCC or Precusor of HCC

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.

Nodular Lesions Seen on CTAP Not on Conventional CT in Known Hepatocellular Carcinoma(HCC) Patients: Positive Predictive Value for HCC or Precusor of HCC

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.

Patterns of Vascular Invasion of Intrahepatic Peripheral Cholangiocarcinoma Examined with Angiography and Angiographic CT

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.

Patterns of Vascular Invasion of Intrahepatic Peripheral Cholangiocarcinoma Examined with Angiography and Angiographic CT

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.

Intrahepatic Branching Patterns of the Right Hepatic Artery: Analysis of Anteroposterior and Oblique Views of the Hepatic Arteriography with the Help of CT Scan

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.