Abstract：Objective To explore the value of CT in the diagnosis and presurgical assessment of resectability of Bismuth-Corlette type-Ⅳ hilar cholangiocarcinoma (HCCA). Methods Fifty-seven patients with pathologically confirmed HCCA from February 2017 to May 2021 were retrospectively analyzed to evaluate the accuracy of CT in the diagnosis of Bismuth-Corlette type-Ⅳ HCCA. Extent of bile duct involvement, hepatic lobe atrophy, vascular invasion and lymph node metastasis in 31 patients with Bismuth-Corlette type-Ⅳ HCCA were analyzed to explore the consistency between CT diagnosis and surgical and pathological results. Results The accuracy of CT in the diagnosis of Bismuth-Corlette type-Ⅳ HCCA was 89.5%. The sensitivity of CT in evaluating the range of bile duct involvement, hepatic lobe atrophy, hepatic artery invasion, portal vein invasion and lymph node metastasis was 70.0%, 100.0%, 75.0%, 83.3% and 69.2%, respectively. The specificity was 90.5%, 100.0%, 91.3%, 94.7% and 83.3%, respectively. The accuracy was 83.9%, 100.0%, 87.1%, 90.3% and 77.4%, respectively. The Kappa value of consistency analysis with surgery was 0.62, 1, 0.66, 0.79 and 0.53, respectively. The Kappa value of CT in preoperative evaluation of resectability of Bismuth-Corlette type-Ⅳ HCCA was 0.68, with a sensitivity of 85.7%, specificity of 82.3% and accuracy of 83.9%. Conclusions CT plays an important role in the diagnosis and presurgical assessment of resectability of Bismuth-Corlette type-Ⅳ HCCA.
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