Head and Neck Imaging

MRI Findings of Intrahepatic Peripheral Cholangiocarcinoma

Author:HU Zhong-hua, ZHOU Ke-feng, KONG Xiao-jian, et al

affiliation:Department of Radiology, Shiqiye Hospital of Maanshan, Maanshan 243000, Anhui Province, China

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Abstract

Objective To improve the accuracy of MRI in diagnosis of intrahepatic peripheral cholangiocarcinoma (IHPCC). Methods MRI data of 12 cases with IHPCC confirmed by surgery or biopsy were retrospectively analyzed. All the cases underwent plain and dynamic contrast-enhanced MR scanning. Signal intensity of the lesions in different sequences and the dynamic enhancement pattern were emphatically analyzed. Results A total of 14 lesions were found in 12 cases, among which 2 cases were accompanied with satellite lesions and other 2 cases with hepatic hemangioma. Ten lesions were round while 4 lesions showed irregular shape. Seven lesions were located at hepatic subcapsule area, and 3 lesions covered multiple lobes. All the lesions showed hypointensity in T1WI and hyperintensity in T2WI (11 lesions with patchy or asteroid hypointense areas). The lesions showed inhomogeneous slightly high signal in DWI (10 lesions showed irregular ring slightly high signal with low signal in the center). Ten lesions showed irregular peripheral circular enhancement in the arterial phase, extended concentric enhancement in the portal venous and delayed phases. Three lesions showed both peripheral and central enhancement in the arterial phase and extended enhancement in the portal venous and delayed phases. One lesion showed due to unobvious enhancement due to its smaller size. Eleven lesions were accompanied with peripheral bile duct dilatation, six among them with intratumoral visible bile duct dilatation. Liver tissue around 8 lesions showed cloudy enhancement in the arterial phase. Adjacent liver capsule shrinkage was found in 9 lesions. Liver lobe atrophy was demonstrated in 3 lesions. Conclusion MRI features of IHPCC were characteristic. Comprehensive analyzation of signal intensities in different sequences, enhancement patterns as well as accompanying signs can improve the diagnostic accuracy of IHPCC.

【Keyword】Liver; Cholangiocarcinoma; Magnetic Resonance Imaging

【Chart number】R322.4+7

【Document Identification Number】A

【DOI】 10.3969/j.issn.1672- 5131.2016.10.028