MALIGNANT HEPATIC HILAR TUMORS - CAN ULTRASONOGRAPHY BE USED AS AN ALTERNATIVE TO ANGIOGRAPHY WITH CT ARTERIAL PORTOGRAPHY FOR DETERMINATION OF RESECTABILITY

Nineteen consecutive patients with malignant hilar obstruction were im aged with angiography, CT portography, and ultrasonography with color and spectral Doppler technique; all had surgical pathologic correlatio n. At surgery, 12 of 19 patients (63%) were found to have portal vein involvement; 15 of 19 (79%) had parenchymal invasion; and 11 of 19 (58 %) had lobar atrophy. Level of biliary obstruction was determined in s even of 19 patients (37%) without drainage catheters. No difference wa s found between ultrasonography and angiography with CT portography fo r diagnosis of atrophy, level of bile duct obstruction, hepatic involv ement, or venous invasion. Extrahepatic metastases in nine of 19 patie nts (47%) were poorly predicted by both CT portography and ultrasonogr aphy.