Skip to main content
Top
Published in: Japanese Journal of Radiology 1/2017

01-01-2017 | Original Article

Periportal low attenuation associated with liver metastasis from colorectal cancer: evaluation using multi-detector-row CT with pathological correlation

Authors: Ryo Takaji, Shunro Matsumoto, Maki Kiyonaga, Yasunari Yamada, Hiromu Mori, Yukio Iwashita, Masayuki Ohta, Masafumi Inomata, Naoki Hijiya, Masatsugu Moriyama, Hajime Takaki, Kengo Fukuzawa, Hirotoshi Yonemasu

Published in: Japanese Journal of Radiology | Issue 1/2017

Login to get access

Abstract

Objectives

Periportal low attenuation (PPLA) associated with metastatic liver cancer is occasionally seen on multi-detector-row CT (MDCT). The purpose of this study was to investigate the MDCT patterns of the PPLA and to correlate it with pathological findings.

Methods

We retrospectively reviewed the MDCT images of 63 patients with metastatic liver cancers from colorectal adenocarcinoma. On MDCT scans, PPLA associated with liver metastasis was visualized in six patients with colorectal cancer. In these six patients who had undergone surgical resection, the radiologic-pathologic correlation was analyzed. All patients underwent a single contrast-enhanced MDCT within 1 month before surgical resection. The six liver cancers were pathologically proven to be moderately differentiated adenocarcinoma. We assessed the PPLA on MDCT concerning the distribution patterns and contrast enhancement with pathological correlation.

Results

In five of the patients, the PPLA extended to the hilar side from metastatic liver cancer. Pathologically, there was no cancer invasion into the intra-hepatic periportal area; however, massive lymphedema and fibrosis occurred in all six cases.

Conclusions

PPLA on the hilar and peripheral sides of hepatic metastasis from colorectal cancer may be present suggesting lymphedema and fibrosis of portal tracts not always indicating cancer infiltration.
Literature
1.
go back to reference Lawson TL, Thorsen MK, Erickson SJ, Perret RS, Quiroz FA, Foley WD. Periportal halo: a CT sign of liver disease. Abdom Imaging. 1993;18:42–6.CrossRefPubMed Lawson TL, Thorsen MK, Erickson SJ, Perret RS, Quiroz FA, Foley WD. Periportal halo: a CT sign of liver disease. Abdom Imaging. 1993;18:42–6.CrossRefPubMed
2.
go back to reference Karcaaltincaba M, Haliloglu M, Akpinar E, Akata D, Ozmen M, Ariyurek M, et al. Multidetector CT and MRI findings in periportal space pathologies. Eur Radiol. 2007;61:3–10.CrossRef Karcaaltincaba M, Haliloglu M, Akpinar E, Akata D, Ozmen M, Ariyurek M, et al. Multidetector CT and MRI findings in periportal space pathologies. Eur Radiol. 2007;61:3–10.CrossRef
3.
go back to reference Puplim LF, Vilgrain V, Ronot M, Becker CD, Breguet R, Terraz S. Hepatic lymphatics: anatomy and related diseases. Abdom Imaging. 2015;40:1997–2011.CrossRef Puplim LF, Vilgrain V, Ronot M, Becker CD, Breguet R, Terraz S. Hepatic lymphatics: anatomy and related diseases. Abdom Imaging. 2015;40:1997–2011.CrossRef
4.
5.
go back to reference Coakley FV, O’Reilly EM, Schwartz LW, Panicek DM, Castellino RA. Non-Hodgkin lymphoma as a cause of intrahepatic periportal low attenuation on CT. J Comput Assist Tomogr. 1997;21:726–8.CrossRefPubMed Coakley FV, O’Reilly EM, Schwartz LW, Panicek DM, Castellino RA. Non-Hodgkin lymphoma as a cause of intrahepatic periportal low attenuation on CT. J Comput Assist Tomogr. 1997;21:726–8.CrossRefPubMed
6.
go back to reference Mizukami Y, Ohta H, Arisato S, Nakano Y, Murakami M, Orii Y, et al. Case report: mucinous cholangiocarcinoma featuring a multicystic appearance and periportal collar in imaging. J Gastroenterl Hepatol. 1999;14:1223–6.CrossRef Mizukami Y, Ohta H, Arisato S, Nakano Y, Murakami M, Orii Y, et al. Case report: mucinous cholangiocarcinoma featuring a multicystic appearance and periportal collar in imaging. J Gastroenterl Hepatol. 1999;14:1223–6.CrossRef
7.
go back to reference de Ridder J, de Wilt J, Simmer F, Overbeek L, Lemmens V, Nagtegaal I. Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget. 2016. doi:10.18632/oncotarget.10552. de Ridder J, de Wilt J, Simmer F, Overbeek L, Lemmens V, Nagtegaal I. Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget. 2016. doi:10.​18632/​oncotarget.​10552.
8.
go back to reference Hallet J, Beyfuss K, Memeo R, Karanicolas PJ, Marescaux J, Pessaux P. Short and long-term outcomes of laparoscopic compared to open liver resection for colorectal liver metastases. Hepatobiliary Surg Nutr. 2016;5:300–10.CrossRefPubMedPubMedCentral Hallet J, Beyfuss K, Memeo R, Karanicolas PJ, Marescaux J, Pessaux P. Short and long-term outcomes of laparoscopic compared to open liver resection for colorectal liver metastases. Hepatobiliary Surg Nutr. 2016;5:300–10.CrossRefPubMedPubMedCentral
9.
go back to reference Alseidi A, Helton WS, Espat NJ. Does the literature support an indication for hepatic metastasectomy other than for colorectal primary? J Gastrointest Surg. 2006;10:99–104.CrossRefPubMed Alseidi A, Helton WS, Espat NJ. Does the literature support an indication for hepatic metastasectomy other than for colorectal primary? J Gastrointest Surg. 2006;10:99–104.CrossRefPubMed
10.
go back to reference Ohtani O, Ohtani Y. Lymph circulation in the liver. Anat Rec. 2008;291:643–52.CrossRef Ohtani O, Ohtani Y. Lymph circulation in the liver. Anat Rec. 2008;291:643–52.CrossRef
11.
go back to reference Moore K, editor. Clinically oriented anatomy. 4th ed. Baltimore: Lippincott Williams and Wilkins; 1999. Moore K, editor. Clinically oriented anatomy. 4th ed. Baltimore: Lippincott Williams and Wilkins; 1999.
12.
go back to reference Vidal-Vanaclocha F. The prometastatic microenvironment of the liver. Cancer Micro Environ. 2008;1:113–29.CrossRef Vidal-Vanaclocha F. The prometastatic microenvironment of the liver. Cancer Micro Environ. 2008;1:113–29.CrossRef
14.
15.
go back to reference Krizhanovsky V, Yon M, Dickins RA, Hearn S, Simon J, Miething C, et al. Senescence of activated stellate cells limits liver fibrosis. Cell. 2008;134:657–67.CrossRefPubMedPubMedCentral Krizhanovsky V, Yon M, Dickins RA, Hearn S, Simon J, Miething C, et al. Senescence of activated stellate cells limits liver fibrosis. Cell. 2008;134:657–67.CrossRefPubMedPubMedCentral
16.
go back to reference Bengtsson G, Carlsson G, Hafström L, Jönsson PE. Natural history of patients with untreated liver metastases from colorectal cancer. Am J Surg. 1981;141:586–9.CrossRefPubMed Bengtsson G, Carlsson G, Hafström L, Jönsson PE. Natural history of patients with untreated liver metastases from colorectal cancer. Am J Surg. 1981;141:586–9.CrossRefPubMed
17.
go back to reference Adam R, Vinet E. Regional treatment of metastasis: surgery of colorectal liver metastases. Ann Oncol 2004;15:iv103–6. Adam R, Vinet E. Regional treatment of metastasis: surgery of colorectal liver metastases. Ann Oncol 2004;15:iv103–6.
18.
go back to reference Cyrley SA, Izzo F. Radiofrequency ablation of primary and metastatic liver tumors. Surg Technol Int. 2002;10:99–106. Cyrley SA, Izzo F. Radiofrequency ablation of primary and metastatic liver tumors. Surg Technol Int. 2002;10:99–106.
19.
go back to reference Chen MH, Yang W, Yan K, Gao W, Dai Y, Wang YB, et al. Treatment efficacy of radiofrequency ablation of 338 patients with hepatic malignant tumor and relevant complications. World J Gastroenterol. 2005;11:6395–401.CrossRefPubMedPubMedCentral Chen MH, Yang W, Yan K, Gao W, Dai Y, Wang YB, et al. Treatment efficacy of radiofrequency ablation of 338 patients with hepatic malignant tumor and relevant complications. World J Gastroenterol. 2005;11:6395–401.CrossRefPubMedPubMedCentral
20.
go back to reference Takeuchi K, Kuwano H, Tsuzuki Y, Ando T, Sekihara M, Hara T, et al. Clinicopathological characteristics of poorly differentiated adenocarcinoma of the colon and rectum. Hepatogastroenterology. 2004;51:1698–702.PubMed Takeuchi K, Kuwano H, Tsuzuki Y, Ando T, Sekihara M, Hara T, et al. Clinicopathological characteristics of poorly differentiated adenocarcinoma of the colon and rectum. Hepatogastroenterology. 2004;51:1698–702.PubMed
21.
go back to reference Chung CK, Zaino RJ, Stryker JA. Colorectal carcinoma: evaluation of histologic grade and factors influencing prognosis. J Surg Oncol. 1982;21:143–8.CrossRefPubMed Chung CK, Zaino RJ, Stryker JA. Colorectal carcinoma: evaluation of histologic grade and factors influencing prognosis. J Surg Oncol. 1982;21:143–8.CrossRefPubMed
22.
go back to reference International Union Against Cancer (UICC). Histopathological grading. In: Sobin LH, Wittekind C, editors. TNM classification of malignant tumors, vol. 13. 6th ed. New York: Wiley-Liss; 2002. International Union Against Cancer (UICC). Histopathological grading. In: Sobin LH, Wittekind C, editors. TNM classification of malignant tumors, vol. 13. 6th ed. New York: Wiley-Liss; 2002.
Metadata
Title
Periportal low attenuation associated with liver metastasis from colorectal cancer: evaluation using multi-detector-row CT with pathological correlation
Authors
Ryo Takaji
Shunro Matsumoto
Maki Kiyonaga
Yasunari Yamada
Hiromu Mori
Yukio Iwashita
Masayuki Ohta
Masafumi Inomata
Naoki Hijiya
Masatsugu Moriyama
Hajime Takaki
Kengo Fukuzawa
Hirotoshi Yonemasu
Publication date
01-01-2017
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 1/2017
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-016-0592-9

Other articles of this Issue 1/2017

Japanese Journal of Radiology 1/2017 Go to the issue