[Spiral CT portography in preoperative diagnosis of liver metastases].

Within a period of 12 months we preoperatively performed spiral CT portography (CT-AP) including individual determination of contrast injection kinetics, in 18 consecutive patients. The findings were compared with the microscopic findings in 15 resected specimens. A total of 51 perfusion defects were identified with CT-AP, 40 of which were finally diagnosed as metastases. A total of 36 hepatic lesions were identified at microscopy. 28 of which were metastases, all seen at CT-AP. 12 perfusion defects were misdiagnosed false positive as being of metastatic origin. Thus the sensitivity of CT-AP was 100%, the specificity 65% and the overall accuracy 78%. Therefore, CT-AP using the spiral CT technique is currently the most accurate method for preoperative staging of metastatic disease of the liver. Improvements of the scanning and contrast injection techniques will further improve the clinical value of this examination.