Usefulness of Ultrasonography on Preoperative Detection to Portal Vein Involvement in Patients with Hepatocellular Carcinoma

Shinichi Ueno, Heiji Yoshinaka, Gen Tanabe, Kouichi Kurita, Yoshito Ogura, Shinro Yoshidome, Kensuke Nuruki, Takashi Aikou, Hiroki Inoue*, Masataka Nakajyou*

First Department of Surgery and Radiology*, Faculty of Medicine, Kagoshima University

We evaluated the usefulness of ultrasonography (US) for detection of portal vein involvement (Vp) in preoperative patients with hepatocellular carcinoma (HCC) and compared the results with those of computed tomography during arterial portography (CTAP). In 118 patients (130 lesions) with HCC who underwent US (n=118) and CTAP (n=43) followed by surgery from January 1987 to December 1993, the preoperative imaging findings for Vp (0, 1, 2 or 3) were compared with postoperative histopathologic findings (vp 0, 1, 2 or 3), and ultrasonograms of 125 lesions (excluding vp2 and vp3 cases) were classified into 4 patterns according to the anatomical situation between the tumor and the nearest third order branch of the portal vein as follows: free, hit, contact and adhesion; and the incidence of vp1 in each group was then calculated. We could indicate all of the vp2 and vp3 cases and 15-26% of the vpl cases by US and/or CTAP. A few cases were over or underestimated preoperatively. Sixty percent of contact and adhesion patterns on US were shown to have vpl. Therefore, we conclude that vp2 or vp3 cases are easily detectable by US and/or CTAP compared with the difficulty of vp1 cases, and that contact and adhesion patterns on US should be examined carefully as to the vp factor with various other imaging modalities.

Key words
hepatocellular carcinoma, ultrasonography, computed tomography during arterial portgra-phy, portal vein involvement

Reprint requests
Shinichi Ueno First Department of Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
January 11, 1995

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