Abstract
Although the resolution of ultrasound images are reliable, there is a difficulty in assessing the three dimensional relationship between hepatohilar tumors and the adjacent large vessels such as the portal vein, by machines heretofore in use for hilar cholangiocarcinoma. In this study, we investigated fourteen consecutive cases in order to determine whether three dimension ultrasound (3D-US) imaging, using VOLUSON 530D (MEDISON), could overcome the above mentioned difficulties. The volume data of the echo level was stored around the site of the portal vein bifurcation, and three sector images crossing one another at right angles were prepared by multiplane views. Thus, we analyzed the tumor invasion toward the portal vein via the paracoronal view, which could hardly be assessed by conventional two-dimension ultrasound imaging. Furthermore, we analyzed these relationships using the multi-trimming view, and were able to construct a virtual three-dimensional image. The diagnosis abilities, such as sensitivity and accuracy were 90% and specificity was 75% compared with digital subtraction angiography (DSA) or the intraoperative findings, and an excellent outcome was determined.
In conclusion,3D-US imaging could accurately repres ent the degree of tumor invasion to the hepatic hilum, and was also useful for preoperative diagnosis.
