64-slice spiral CT 3-D angiography(CTA) and 3-D positive contrast CT cholangiography in the preoperative evaluation of patients with hilar cholangiocarcinoma

Objective To study the value of 64-slice spiral CT 3-D angiography (CTA) and 3-D positive contrast CT cholangiography in preoperative evaluation of patients with hilar cholangiocarcinoma.Methods Contrast enhanced abdominal scanning was performed using 64-slice spiral CT.Hepatic artery and portal vein CTA were performed in 8 cases with hilar cholangiocarcinoma.Plain abdominal scanning was performed after 6.9% meglumine diatrizoate was injected into bile duct through PTBD.Positive contrast CT cholangiography was performed for these patients.The level and range of hepatic artery,portal vein and bile duct invasion and preoperative Bismuth-Corlette classification and T-Staging were recorded and compared with surgical exploration.Results Successfully hepatic artery,portal vein and bile duct reconstruction were performed for all these patients and complete intrahepatic bile duct cholangiography including 1st to 4th order of bile duct in 6 patients.In the other 2 patients,partial negative intrahepatic bile duct cholangiography were recorded due to 2nd to 3rd order of bile duct incomplete contrast filling.In Bismuth-Corlette classification and T-Staging system,7 patients and 6 patients were respectively in accordance with surgical exploration.Conclusion 64-slice spiral CT 3-D angiography (CTA) and 3-D positive contrast CT cholangiography were effective in assessing tumor blood vessel and bile duct invasion in patients with hilar cholangiocarcinoma.Its usefulness in the guidance of clinical therapy deserves further investigation.