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Published in: World Journal of Surgery 7/2009

01-07-2009

Value of Multidetector Row CT in the Assessment of Longitudinal Extension of Cholangiocarcinoma—Correlation Between MDCT and Microscopic Findings

Authors: Yoshiki Senda, Hideki Nishio, Koji Oda, Yukihiro Yokoyama, Tomoki Ebata, Tsuyoshi Igami, Teiichi Sugiura, Yoshie Shimoyama, Yuji Nimura, Masato Nagino

Published in: World Journal of Surgery | Issue 7/2009

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Abstract

Background

A few authors have reported the value of multidetector row CT (MDCT) for evaluating the longitudinal extent of cholangiocarcinoma. They have not focused on CT attenuation of a tumor and actual tumor extent along the bile ducts. We designed the present study to analyze attenuation.

Methods

Between January 2003 and July 2005, 113 consecutive patients with cholangiocarcinoma underwent a surgical resection following MDCT. Of these MDCT studies, 73 (perihilar cholangiocarcinoma, n = 62; middle and distal cholangiocarcinoma, n = 11) were suitable for analysis, and the patients were enrolled in the study. Patients were divided according to tumor hypoattenuation and hyperattenuation on MDCT. Histologic differentiation, desmoplastic reaction, and vascular density were microscopically compared with the tumor attenuation to differentiate the characteristics of the attenuation. The extent of cancer along the bile duct diagnosed by MDCT was compared with the actual extent determined by the microscopic findings.

Results

Hyperattenuated tumor was observed in 40 patients. There was no difference in histologic differentiation, desmoplastic reaction, or vascular density between the hyperattenuated and hypoattenuated cholangiocarcinomas. Neither the proximal nor the distal borders between the normal and thickened bile duct wall could be determined in the 33 patients with hypoattenuated tumor; in contrast, an accurate assessment of extent of tumor was obtained in 76% of the proximal borders and 82% of the distal borders in the 40 patients with hyperattenuated tumor.

Conclusions

Although the cause of the difference between the hyperattenuated and hypoattenuated cholangiocarcinoma still is unclear, MDCT can be an alternative to direct cholangiography in selected patients with hyperattenuated cholangiocarcinoma.
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Metadata
Title
Value of Multidetector Row CT in the Assessment of Longitudinal Extension of Cholangiocarcinoma—Correlation Between MDCT and Microscopic Findings
Authors
Yoshiki Senda
Hideki Nishio
Koji Oda
Yukihiro Yokoyama
Tomoki Ebata
Tsuyoshi Igami
Teiichi Sugiura
Yoshie Shimoyama
Yuji Nimura
Masato Nagino
Publication date
01-07-2009
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 7/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-009-0025-3

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