Detection of recurrent hepatic metastases after partial hepatectomy: value of CT combined with arterial portography.
OBJECTIVE
We did a retrospective study to evaluate the sensitivity of CT combined with arterial portography in detecting recurrent hepatic metastases after partial hepatectomy.


METHODS
CT scans combined with arterial portography in 18 patients who had partial hepatectomy and suspected intrahepatic recurrence of metastases were retrospectively reviewed. Eleven of the patients had further surgery, and recurrent hepatic metastases were proved; seven patients were inoperable. The sensitivity of CT with arterial portography for detecting recurrent intrahepatic metastases was determined and correlated with intraoperative findings and findings on follow-up imaging studies in the 11 patients (with a total of 23 hepatic metastases) who had further surgery.


RESULTS
Not one of the 18 CT examinations combined with arterial portography was compromised by inhomogeneous perfusion of contrast material in the portal vein. Of the 23 metastases that were found in the 11 patients who had further surgery, 21 (91%) were shown on CT with arterial portography. In two patients, CT with arterial portography showed two subcapsular hypoattenuating pseudolesions that were correctly identified as nontumorous perfusion defects, as confirmed by intraoperative findings and follow-up imaging studies.


CONCLUSIONS
This study shows that postoperative CT with arterial portography is efficacious in the detection of intrahepatic recurrent metastases in patients who have had a partial hepatectomy. Furthermore, prior partial hepatectomy does not compromise the quality of this examination.
Soyer
P
P
Department of Radiology, Johns Hopkins Hospital, Baltimore, MD 21205-2180.
Bluemke
D A
DA
Zeitoun
G
G
Marmuse
J P
JP
Levesque
M
M
D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary; D011172:Portography / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*