Abstract:Objective To investigate the diagnostic capabilities of multi-detector spiral computed tomography (MDCT) in detecting the involvements at different levels of bile ducts in hilar cholangiocarcinoma (HCCA) taking the surgical result as a standard. Methods The MDCT images of 23 HCCA patients confirmed by surgery and pathology from January 2013 to December 2015 were analyzed retrospectively to judge whether the common hepatic duct, the confluence position of left and right hepatic ducts and the confluence position of bilateral grade 2 bile ducts were violated, and the typing was made according to Bismuth-Corlette classification, and the results were compared with those of the operation and pathology. Results According to MDCT images, there were 2 cases of type Ⅰ, 2 cases of type Ⅱ, 3 cases of Ⅲa, 2 cases of type Ⅲb, and 14 cases of type Ⅳ. According to pathology results, there were 2 cases of type Ⅰ, 3 cases of type Ⅱ, 3 cases of Ⅲa, 4 cases of type Ⅲb, and 11 cases of type Ⅳ in 23 patients. The sensitivity, specificity and accuracy of MDCT for detecting the involvement of hepatic hilar bile ducts were 100%, 100% and 100% in common hepatic duct, 100%, 100% and 100% in confluence position of left and right hepatic ducts, 100%, 87.5%, 95.7% in confluence position of grade 2 left hepatic duct, 100%, 66.7% and 87.0% in confluence position of grade 2 right hepatic duct.The accuracy of MDCT for HCCA typing was 87.0 % and had a good consistency with surgical and pathological typing (Kappa=0.802, P=0.000). Conclusion Although MDCT has a higher accuracy, the diagnostic efficacy for the involvement in each segment of bile duct in the hepatic portal position is not consistent, especially the detection capability is limited for the lesion of confluence position of grade 2 right hepatic duct.