title: Diagnostic ability of MDCT to assess right hepatic artery invasion by perihilar cholangiocarcinoma with left-sided predominance.
abstract: OBJECTIVE
  There have been few reports on the diagnostic ability of multidetector-row computed tomography (MDCT) to assess invasion of the hepatic artery. The aim of this study was to assess the diagnostic ability of MDCT for right hepatic artery (RHA) invasion.
  
  
  METHODS
  From August 2006 to October 2010, 103 consecutive patients with left-sided predominance perihilar cholangiocarcinoma underwent left-sided hepatectomy; all patients received MDCT as a preoperative workup. Three-dimensional volume-rendered and multiplanar reformation (MPR) images were retrospectively examined for evidence of RHA invasion, and the agreement between intraoperative macroscopic and histologic findings was assessed.
  
  
  RESULTS
  No macroscopic evidence of RHA invasion was found in any of the 50 patients presenting visible low-density planes on MPR images between the RHA and adjacent tumor. Of the remaining 53 patients without visible low-density planes, 38 patients presented macroscopic evidence of RHA invasion and underwent combined RHA resection; the other 15 patients did not exhibit RHA invasion. The RHA contact length, as measured on MDCT images by curved planar reformations, was significantly longer in the former 38 patients than in the latter 15 patients (24.3 ± 16.9 vs. 8.6 ± 3.0 mm, respectively, P = 0.001). Histologic cancer infiltration of the resected RHA was found in 18 (47.4%) of the 38 patients who underwent RHA resection. Diagnosis of macroscopic RHA invasion based on the presence or absence of a low-density plane had an accuracy of 85.4%.
  
  
  CONCLUSIONS
  We conclude that MDCT is useful for assessing RHA invasion by perihilar cholangiocarcinoma.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fukami
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ebata
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Igami
authors.forename: Gen
authors.initials: G
authors.lastname: Sugawara
authors.forename: Yu
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Kojiro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009361:Neoplasm Invasiveness; D015203:Reproducibility of Results; D012189:Retrospective Studies