Intrahepatic portal spreading and its extent of multiple hepatocellular carcinomas were assessed by multi-detector CT to confirm theoretical background of anatomical resection. 44 patients were examined and a main tumor was classified into Hilar type and Peripheral type. In Peripheral type, a number of the relevant portal branches was 1 or 2, and extent of the accessory tumors were relatively localized. In 43% of the cases, accessory tumors located within the sub-segment of 3rd relevant portal branch. And, in 79% of cases, those located within the lobe of 1st relevant portal branch. However, local ablation thought not to be coped for the possible portal spreading tumors. In Hilar type, a number of the relevant portal branches were many and accessory tumors were spread extensively. In conclusion, resection of the relevant portal segment of the main tumor as wide as a grade of hepatic extent should be curative for Peripheral type hepatocellular carcinoma.
