COMPUTED TOMOGRAPHIC PORTOGRAPHY IN PREOPERATIVE IMAGING OF HEPATIC NEOPLASMS

Preoperative selection of suitable patients for liver resection is dep endent on the quality of radiological imaging. Computed tomography (CT ) approximately 70 per cent of lesions. tomographic arterial portograp hy (CTAP) during contrast enhancement of the liver via the portal vein may be superior to conventional CT. Preoperative CTAP was evaluated i n 60 patients with hepatic neoplasm (48 having colorectal metastases) who subsequently underwent laparotomy. The preoperative images were co mpared with intraoperative palpation, intraoperative ultrasonography a nd histology of the resected liver. Fifty-six patients (93 per cent) u nderwent partial hepatectomy. The detection rate sensitivity for CTAP was 110 of 116 lesions in the 56 patients (95 per cent) and for intrao perative ultrasonography was 114 of 116 (98 per cent). CTAP correctly identified all lesions found at histology in 50 of 56 (89 per cent) re sected specimens. At laparotomy four of 60 patients (7 per cent) were inoperable; two of these had been predicted to be so by this technique . CTAP correctly identifies and locates the majority of hepatic tumour s, particularly metastases, and is the procedure of choice for selecti on of suitable candidates for partial hepatectomy.