Objective      To explore the imaging features of hepatocellular carcinoma (HCC) with blood supply from omental artery (OA) and the clinical value of complete transcatheter arterial chemoembolization (TACE).       Methods      The image data and clinical data of patients with HCC with blood supply from OA

who underwent TACE in our hospital from 2010 to 2014

were collected. The imaging features were analyzed

and the safety and effectiveness of complete TACE were evaluated retrospectively.       Results      HCC with blood supply from OA was found in 36 patients who underwent TACE for 41 times. In all patients

tumors showed exophytic growth. The tumors of 13 patients (31.7%) were mainly located in liver segments 4-5 and showed exophytic growth in epiploic direction. The tumors of 18 patients (43.9%) were mainly located in liver segments 5-6 and downwards broke through the hepatic capsule. There were 53 OAs found to supply blood to HCC

and angiographic features were clear. Totally

49 OAs (92.5%) were completely occlusive

and no serious complication was recorded. Among 28 cases analyzed with a modified response evaluation criteria in solid tumor (mRECIST) method

there were 9 cases in complete response (CR)

13 cases in partial response (PR)

2 cases in stable disease (SD)

and 4 cases in progressive disease (PD). Response rate (RR) was 78.6%

and disease control rate (DCR) was 85.7%. Fifteen cases underwent the next TACE

and only 2 cases had new OAs found to supply blood to tumors.       Conclusion      OAs mostly involve in blood supply of massive HCC

which is located in liver segments 4-6 and breaks through the hepatic capsule or infringes the neighboring greater omentum

and vascular imaging features are clear. Complete chemoembolization of OAs is a relatively safe

feasible and valuable method.