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Peripheral mass-forming cholangiocarcinoma in cirrhotic liver

Cited 79 time in Web of Science Cited 90 time in Scopus
Authors
Kim, Su Jin; Lee, Jeong Min; Han, Joon Koo; Kim, Ki Hyun; Lee, Jae Young; Choi, Byung Ihn
Issue Date
2007
Publisher
American Roentgen Ray Society
Citation
AJR 2007; 189:1428-1434
Keywords
AdultAgedAged, 80 and overBile Duct Neoplasms/complications/*radiographyBile Ducts, Intrahepatic/*radiographyCarcinoma, Hepatocellular/complications/*radiographyCholangiocarcinoma/complications/*radiographyContrast MediaDiagnosis, DifferentialFemaleHumansLiver Cirrhosis/complications/*radiographyLiver Neoplasms/complications/*radiographyMaleMiddle AgedRadiographic Image Enhancement/*methodsReproducibility of ResultsSensitivity and SpecificityTomography, X-Ray Computed/methods
Abstract
OBJECTIVE: The purpose of this study was to determine whether particular enhancement patterns of intrahepatic cholangiocarcinoma in cirrhotic liver suggest the correct diagnosis. MATERIALS AND METHODS: The CT findings on 28 lesions in 26 patients with underlying liver cirrhosis and pathologically proven cholangiocarcinoma were retrospectively evaluated. The CT findings of hepatocellular carcinoma (HCC) in a control group of 79 subjects also were analyzed. The relative attenuation and enhancement pattern of the lesions were evaluated by two observers in consensus. The difference between the enhancement pattern of cholangiocarcinoma and that of HCC was statistically analyzed with the Fisher's exact test. RESULTS: The prevalent enhancement patterns of cholangiocarcinoma on enhanced CT scans differed depending on tumor size. Peripheral rimlike enhancement was the most frequent (nine of 20 cases) pattern in tumors larger than 3 cm in diameter. A washout pattern on portal venous phase scans was the most frequent (five of eight cases) in tumors smaller than 3 cm in diameter. For tumors smaller than 3 cm in diameter, there was no significant difference between the enhancement pattern of cholangiocarcinoma and that of HCC. For tumors larger than 3 cm, the presence of peripheral rimlike enhancement or centripetal enhancement and the absence of a washout pattern were significant findings for differentiating cholangiocarcinoma from HCC (p < 0.0001). CONCLUSION: The contrast enhancement patterns of cholangiocarcinoma in cirrhotic liver on multiphasic helical CT scans were found to differ depending on tumor size. Because of the overlapping imaging findings in the two diseases, for any hypovascular lesion smaller than 3 cm in a cirrhotic liver, the diagnosis of cholangiocarcinoma should be seriously considered along with that of HCC.
ISSN
1546-3141 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18029881

http://hdl.handle.net/10371/10473
DOI
https://doi.org/10.2214/AJR.07.2484
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Radiation Applied Life Science (대학원 협동과정 방사선응용생명과학전공)Journal Papers (저널논문_방사선응용생명과학전공)
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