Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma.

The purpose of our study was to assess the potential of thin-section multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinomas.Identically collimated helical CT studies were performed before and during the hepatic artery dominant phase and during the portal vein dominant phase of contrast enhancement in 29 consecutive patients with proven hilar cholangiocarcinomas. Differences in attenuation between the tumor and the liver were calculated in each case by subtracting the average attenuation of the tumor from that of the liver. A four-point scale termed a "lesion conspicuity score" was used to determine rates of tumor detection. CT findings were correlated with surgically assessed extent of tumor, histologic findings, or both in all cases.Ten (34%) of the 29 hilar cholangiocarcinomas were detected on unenhanced images. All hilar cholangiocarcinomas (100%) were seen on hepatic artery dominant phase scans, and 25 (86%) of 29 hilar cholangiocarcinomas were seen on portal vein dominant phase ...