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Hepatic parenchymal perfusion abnormalities after pancreaticobiliary surgery. Evaluation with dynamic helical CT
K Mitsuzaki1, Y Yamashita, I Ogata
1Department of Radiology, Kumamoto University School of Medicine, Japan.
Purpose:
To evaluate perfusion abnormalities of the liver after pancreaticobiliary surgery.
Material And Methods:
We retrospectively evaluated 128 patients with pancreaticobiliary malignant tumors who had been examined both before and after surgery by means of helical CT of the liver. An infusion of 3 ml/s of 60% nonionic contrast material was followed by helical CT of the liver in a sequential arterial phase, portal venous phase, and equilibrium phase.
Results:
Of 128 patients, we followed 97. In 21 patients (22%) we found 47 lesions with perfusion abnormalities that were detected 1-33 months (mean 6.6 months) after the operation. All patients were asymptomatic. The shape of each perfusion abnormality was characterized as geographic (n = 23, 47%), wedge-shaped (n = 21, 45%), or round (n = 3, 8%). The abnormalities were seen in the arterial phase in 46 lesions (98%), in the portal venous phase in 18 lesions (38%), and in the equilibrium phase in 1 lesion (0.2%). In all lesions, the size either decreased spontaneously, or it remained unchanged for more than one year.
Conclusion:
Perfusion abnormalities of the liver may occur in patients who undergo pancreaticobiliary surgery. This findings should not be confused with hypervascular metastases.