Ryo Takaji1, Shunro Matsumoto2, Maki Kiyonaga1, Yasunari Yamada1, Hiromu Mori1, Yukio Iwashita3, Masayuki Ohta3, Masafumi Inomata3, Naoki Hijiya4, Masatsugu Moriyama4, Hajime Takaki5, Kengo Fukuzawa6, Hirotoshi Yonemasu7. 1. Departments of Radiology, Oita University Faculty of Medicine, Yufu City, Oita, 879-5593, Japan. 2. Departments of Radiology, Oita University Faculty of Medicine, Yufu City, Oita, 879-5593, Japan. matsushu@oita-u.ac.jp. 3. Departments of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu City, Oita, Japan. 4. Departments of Molecular Pathology, Oita University Faculty of Medicine, Yufu City, Oita, Japan. 5. Departments of Radiology, Oita Red-cross Hospital, Oita, Japan. 6. Departments of Surgery, Oita Red-cross Hospital, Oita, Japan. 7. Departments of Pathology, Oita Red-cross Hospital, Oita, Japan.
Abstract
OBJECTIVES: Periportal low attenuation (PPLA) associated with metastatic liver cancer is occasionally seen on multi-detector-row CT (MDCT). The purpose of this study was to investigate the MDCT patterns of the PPLA and to correlate it with pathological findings. METHODS: We retrospectively reviewed the MDCT images of 63 patients with metastatic liver cancers from colorectal adenocarcinoma. On MDCT scans, PPLA associated with liver metastasis was visualized in six patients with colorectal cancer. In these six patients who had undergone surgical resection, the radiologic-pathologic correlation was analyzed. All patients underwent a single contrast-enhanced MDCT within 1 month before surgical resection. The six liver cancers were pathologically proven to be moderately differentiated adenocarcinoma. We assessed the PPLA on MDCT concerning the distribution patterns and contrast enhancement with pathological correlation. RESULTS: In five of the patients, the PPLA extended to the hilar side from metastatic liver cancer. Pathologically, there was no cancer invasion into the intra-hepatic periportal area; however, massive lymphedema and fibrosis occurred in all six cases. CONCLUSIONS: PPLA on the hilar and peripheral sides of hepatic metastasis from colorectal cancer may be present suggesting lymphedema and fibrosis of portal tracts not always indicating cancer infiltration.
OBJECTIVES: Periportal low attenuation (PPLA) associated with metastatic liver cancer is occasionally seen on multi-detector-row CT (MDCT). The purpose of this study was to investigate the MDCT patterns of the PPLA and to correlate it with pathological findings. METHODS: We retrospectively reviewed the MDCT images of 63 patients with metastatic liver cancers from colorectal adenocarcinoma. On MDCT scans, PPLA associated with liver metastasis was visualized in six patients with colorectal cancer. In these six patients who had undergone surgical resection, the radiologic-pathologic correlation was analyzed. All patients underwent a single contrast-enhanced MDCT within 1 month before surgical resection. The six liver cancers were pathologically proven to be moderately differentiated adenocarcinoma. We assessed the PPLA on MDCT concerning the distribution patterns and contrast enhancement with pathological correlation. RESULTS: In five of the patients, the PPLA extended to the hilar side from metastatic liver cancer. Pathologically, there was no cancer invasion into the intra-hepatic periportal area; however, massive lymphedema and fibrosis occurred in all six cases. CONCLUSIONS: PPLA on the hilar and peripheral sides of hepatic metastasis from colorectal cancer may be present suggesting lymphedema and fibrosis of portal tracts not always indicating cancer infiltration.