Evaluation of CT during arterial portography for preoperative diagnosis of intrahepatic cholangiocarcinoma.
OBJECTIVE
To evaluate computed tomography during arterial portography for preoperative evaluation in patients with intrahepatic cholangiocarcinoma.


METHODS
Computed tomography during arterial portography was performed in 11 intrahepatic cholangiocarcinoma patients undergoing hepatectomy. Segmental perfusion defect, sensitivity of the main tumor, and sensitivity of intrahepatic metastasis on computed tomography during arterial portography were retrospectively evaluated.


RESULTS
In 9 of 11 patients (81.8%), a segmental perfusion defect was seen. The sensitivities for detecting the main tumor and intrahepatic metastasis were 81.8% and 20%, respectively. In 2 patients, the main tumors existed in segmental perfusion defects and thus were not depicted. In 4 false-negative cases, intrahepatic metastatic lesions existed in the segments that were the counterparts of segmental perfusion defects on computed tomography during arterial portography.


CONCLUSIONS
The sensitivity of computed tomography during arterial portography for diagnosing intrahepatic cholangiocarcinoma and its intrahepatic metastasis was low due to segmental perfusion defect. It is necessary for intrahepatic cholangiocarcinoma to be subjected to systematic segmentectomy including all areas corresponding to the segmental perfusion defect.
Miura
Fumihiko
F
Department of Academic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. f-miura@med.teikyo-u.ac.jp
Okazumi
Shinichi
S
Takayama
Wataru
W
Asano
Takehide
T
Makino
Harufumi
H
Shuto
Kiyohiko
K
Ochiai
Takenori
T
Takada
Tadahiro
T
Yasuda
Hideki
H
Nagashima
Ikuo
I
Amano
Hodaka
H
Yoshida
Masahiro
M
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D011172:Portography; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed
D003287:Contrast Media