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Primary malignant neoplasms of the liver: detection with helical CT during arterial portography
P Soyer1, D A Bluemke, R H Hruban
1Department of Radiology, Johns Hopkins Hospital, Baltimore, Md.
Purpose:
To assess the sensitivity of helical computed tomography during arterial portography (CTAP) in the detection of primary malignant neoplasms of the liver.
Materials And Methods:
Preoperative helical CTAP examinations of 19 patients (13 men, six women, aged 33-78 years) with primary malignant neoplasms of the liver (hepatoma, n = 12; cholangiocarcinoma, n = 4; angiosarcoma, n = 1; biliary cystadenoma, n = 1; hepatoblastoma, n = 1) were retrospectively reviewed by three radiologists. Imaging findings were correlated with intraoperative and pathologic findings.
Results:
A total of 29 separate malignant neoplastic nodules (mean diameter, 6.6 cm) were identified in the resected specimens (16 patients) or intraoperatively in three patients. The overall sensitivity of helical CTAP was 72%; for neoplasms with a diameter less than 1.0 cm, 25%; for neoplasms 1.1-2.0 cm and 2.1-4.0 cm, 25% and 67%, respectively; and for neoplasms over 4.0 cm, 100%.
Conclusion:
The overall sensitivity of helical CTAP in the preoperative detection of primary malignant hepatic neoplasms is low.