J Korean Radiol Soc.  1995 Nov;33(5):763-769.

Periportal Low Attenuation on CT in Patients with Gastric Carcinoma after Radical Surgery

• Lee SH
• Kim SH
• Kim JH
• Han YM
• Choi KC
• Kim CS
• Lee SY
• Chung GH
• Sohn MH
• Jeong TG

Abstract

PURPOSE
Periportal low attenuation, defined as low attenuation rim around the portal vein and its branches on contrast material-enhanced CT scans, has been described in a variety of conditions. We tried to document the major causes of periportal low attenuation in patients with gastric carcinoma after radical surgery.
MATERIALS AND METHODS
The early postoperative CT images of two groups were analyzed and compared. One group(n:9) underwent R2(group 1 and group 2 lymph node) dissection only, while the other(n--9) underwent R2 dissection extended to the hepatoduodenal ligament node. Follow-up CT scans were obtained in five patients with peri portal low attenuatioi~ at 1, 3, 5 months after surgery. In addition, we retrospectively analyzed the 52 cases who underwent gastric surgery for gastric carcinoma showing periportal low attenuation at CT.
RESULTS
Periportal low attenuation was seen in 8(89%) of 9 patients who underwent R2 dissection extended to the hepatoduodenal ligament node, and not seen in 9 patients who underwent R2 dissection only. Follow-up CT scan revealed disappearance of periportal low attenuation in 60%, 80%, 100% at 1, 3, 5 months respectively. In 32 of 52 cases(62%) periportal low attenuation was reversible and in 9 of 52 cases(17% ) lympha-denopathy in hepatic hilum was the main additional finding.
CONCLUSION
The extensive lymph node dissection extended to the hepatoduodenal ligament node may be the major cause of periportal low attenuation at CT in patients with gastric carcinoma after surgery, but other factor probably contribute to their occurence in the later postoperative CT scans, especially such as metastatic lymphadenopathy.

MeSH Terms

Follow-Up Studies
Humans
Ligaments
Lymph Node Excision
Lymphatic Diseases
Portal Vein
Retrospective Studies
Tomography, X-Ray Computed