Diagnostic ability of MDCT to assess right hepatic artery invasion by perihilar cholangiocarcinoma with left-sided predominance.

BACKGROUND/PURPOSE: 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.