Evaluation of Resectability for Carcinoma of the Gallbladder with Dual-phase Multislice Spiral CT / 实用放射学杂志

ABSTRACT

Objective To evaluate the value of dual-phase MSCT with 3D reconstruction in the staging and resectability of gallbladder carcinoma.Methods Forty patients with suspected gallbladder carcinoma by clinical examination and routine sonography were prospectively studied with dual-phase MSCT. Of these patients, only 35 who underwent a laparotomy for extended cholecystectomy or a palliative surgery were included in the study. Three-dimensional volume rendering and multiplanar reformation was used for evaluation of the vascular invasion and anatomy. The staging and resectability of lesions determined by CT and the results were compared with operative findings.Results On the basis of the CT findings, 13 tumors were resectable and 22 were unresectable. On surgery, 17 tumors were found to be resectable and the remaining was unresectable. Overstaging by CT occurred in 4 patients due to overassessment of duodenal infiltration, pancreatic infiltration and colonal infiltration. CT had a sensitivity of 76.5, a specificity of 100, an accuracy of 88.6, a positive predictive value of 100 and negative predictive value of 81.8 in determining resectability of gallbladder carcinoma. For the diagnosis of hepatic and vascular invasion, and involvement of bile duct by the tumor, there was 100 correlation between CT and surgery. Vascular variations were found in six of 17 patients who underwent radical cholecystectomy.Conclusion Dual-phase MDCT with 3D reconstruction can predict resectability of gallbladder carcinoma and determine the vascular road map before surgery.