Preoperative multi-slice spiral CT evaluation of involvement of vessels and biliary ducts in hepatic cystic echinococcosis

Abstract

Objective To analyze the MSCT imaging of vascular and biliary ducts affected by hepatic cystic enchionococcosis disease(HCD),and to evaluate the 3D image reconstruction of MSCT.Methods Forty four cases with HCD confirmed by radical surgery were collected in this study.All cases underwent multi-phase scanning with 64-slices CT,and 3D image reconstruction of hepatic vessels was performed.Three cases suspected of bile duct complications were examined with negative CT cholangiography.All the imaging data were acquired before surgery.The spatial relationships between the cysts and the neighbor vessels and(or)bile ducts were compared with the findings during operation,then consistency was tested.Results Altogether 46 lesions were detected by MSCT before surgery.All lesions were found and diagnosed correctly,including 3 lesions rupturing into biliary duct Compared with surgery findings,the spatial relationships between lesions and the vessels were entirely consistent in first grade portal vein(14 cases)and inferior macular vein(18 cases).The Kappa values were 0.8805,0.6087,0.7751,0.7392 for first grade hepatic artery,second grade hepatic artery,second grade portal vein and hepatic vein.The relationships between bile ducts and lesions also matched in 3 bile-duct fistula cases.Conclusions MSCT with its 3D technique showed a high accuracy in the assessment of spatial relationship between vessels,biliary duct and lesions.It provides comprehensive imaging information for surgery. Key words: Echinococcosis,hepatic; Tomography,X-ray computed; Comparative study