Contrast‑enhanced multiple‑phase imaging features of intrahepatic mass‑forming cholangiocarcinoma and hepatocellular carcinoma with cirrhosis: A comparative study

Chen,Ying; Pan,Yao; Shen,Ke‑Ren; Zhu,Xiu‑Liang; Lu,Chen‑Ying; Li,Qing‑Hai; Han,Shu‑Gao; Fu,Yan‑Biao; Xu,Xiu‑Fang; Yu,Ri‑Sheng

doi:10.3892/ol.2017.6656

October-2017 Volume 14 Issue 4

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October-2017 Volume 14 Issue 4

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Article Open Access

Contrast‑enhanced multiple‑phase imaging features of intrahepatic mass‑forming cholangiocarcinoma and hepatocellular carcinoma with cirrhosis: A comparative study

Authors:
- Ying Chen
- Yao Pan
- Ke‑Ren Shen
- Xiu‑Liang Zhu
- Chen‑Ying Lu
- Qing‑Hai Li
- Shu‑Gao Han
- Yan‑Biao Fu
- Xiu‑Fang Xu
- Ri‑Sheng Yu
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Affiliations: Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, P.R. China, Department of Pathology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, P.R. China, Department of Radiology, Hangzhou Medical College, Hangzhou 310053, P.R. China

Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 4213-4219
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Published online on: July 24, 2017

https://doi.org/10.3892/ol.2017.6656
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Abstract

The intrahepatic mass‑forming cholangiocarcinoma (IMCC) is frequently misdiagnosed as hepatocellular carcinoma (HCC) in patients with cirrhosis, by numerous radiologists and clinical doctors, which results in the incorrect therapeutic treatment. A retrospective case‑control study was conducted, and the contrast‑enhanced multiple‑phase (CEMP) computed tomography (CT) and magnetic resonance imaging (MRI) findings of 22 pathologically confirmed IMCC patients and 22 HCC controls with underlying liver cirrhosis were analyzed at the present hospital, from January 2010 to December 2015. In addition, serum tests were conducted and clinical symptoms of patients evaluated. A statistical analysis revealed that the enhancement pattern, signal on MRI delayed phase (P<0.001), maximum diameter, capsule retraction, portal vein invasion, bile duct dilation and abdominal lymphadenectasis characteristics were different between IMCC and HCC patients with cirrhosis. On CEMP CT and MRI analysis, the most frequently occurring enhancement patterns of IMCC were progressive patterns (P=0.001 or P<0.001). Conversely, the most frequently occurring enhancement patterns present in HCC were the washout patterns (P<0.001). Therefore, the diagnosis of IMCC in cirrhotic patients should be verified with CEMP CT and MRI analysis for the future, to determine presence or absence of progressive and/or peripheral rim‑like enhancement, a hyperintensive delayed phase with capsule retraction, portal vein invasion, bile duct dilation, abdominal lymphadenectasis and increased levels of CA199.

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1	Tyson GL and El-Serag HB: Risk factors for cholangiocarcinoma. Hepatology. 54:173–184. 2011. View Article : Google Scholar : PubMed/NCBI
2	Kim SA, Lee JM, Lee KB, Kim SH, Yoon SH, Han JK and Choi BI: Intrahepatic mass-forming cholangiocarcinomas: Enhancement patterns at multiphasic CT, with special emphasis on arterial enhancement pattern-Correlation with clinicopathologic findings. Radiology. 260:148–157. 2011. View Article : Google Scholar : PubMed/NCBI
3	Lim JH: Cholangiocarcinoma: Morphologic classification according to growth pattern and imaging findings. AJR Am J Roentgenol. 181:819–827. 2003. View Article : Google Scholar : PubMed/NCBI
4	Sheng RF, Zeng MS, Rao SX, Ji Y and Chen LL: MRI of small intrahepatic mass-forming cholangiocarcinoma and atypical small hepatocellular carcinoma (≤3 cm) with cirrhosis and chronic viral hepatitis: A comparative study. Clin Imaging. 38:265–272. 2014. View Article : Google Scholar : PubMed/NCBI
5	Forner A, Llovet JM and Bruix J: Hepatocellular carcinoma. Lancet. 379:1245–1255. 2012. View Article : Google Scholar : PubMed/NCBI
6	Rimola J, Forner A, Reig M, Vilana R, de Lope CR, Ayuso C and Bruix J: Cholangiocarcinoma in cirrhosis: Absence of contrast washout in delayed phases by magnetic resonance imaging avoids misdiagnosis of hepatocellular carcinoma. Hepatology. 50:791–798. 2009. View Article : Google Scholar : PubMed/NCBI
7	Palmer WC and Patel T: Are common factors involved in the pathogenesis of primary liver cancers? A meta-analysis of risk factors for intrahepatic cholangiocarcinoma. J Hepatol. 57:69–76. 2012. View Article : Google Scholar : PubMed/NCBI
8	Blechacz B and Gores GJ: Cholangiocarcinoma: Advances in pathogenesis, diagnosis, and treatment. Hepatology. 48:308–321. 2008. View Article : Google Scholar : PubMed/NCBI
9	Kim SJ, Lee JM, Han JK, Kim KH, Lee JY and Choi BI: Peripheral mass-forming cholangiocarcinoma in cirrhotic liver. AJR Am J Roentgenol. 189:1428–1434. 2007. View Article : Google Scholar : PubMed/NCBI
10	Quaia E, Angileri R, Arban F, Gennari AG and Cova MA: Predictors of intrahepatic cholangiocarcinoma in cirrhotic patients scanned by gadobenate dimeglumine-enhanced magnetic resonance imaging: Diagnostic accuracy and confidence. Clin Imaging. 39:1032–1038. 2015. View Article : Google Scholar : PubMed/NCBI
11	Iavarone M, Piscaglia F, Vavassori S, Galassi M, Sangiovanni A, Venerandi L, Forzenigo LV, Golfieri R, Bolondi L and Colombo M: Contrast enhanced CT-scan to diagnose intrahepatic cholangiocarcinoma in patients with cirrhosis. J Hepatol. 58:1188–1193. 2013. View Article : Google Scholar : PubMed/NCBI
12	Khan SA, Thomas HC, Davidson BR and Taylor-Robinson SD: Cholangiocarcinoma. Lancet. 366:1303–1314. 2005. View Article : Google Scholar : PubMed/NCBI
13	Ciresa M, De Gaetano AM, Pompili M, Saviano A, Infante A, Montagna M, Guerra A, Giuga M, Vellone M, Ardito F, et al: Enhancement patterns of intrahepatic mass-forming cholangiocarcinoma at multiphasic computed tomography and magnetic resonance imaging and correlation with clinicopathologic features. Eur Rev Med Pharmacol Sci. 19:2786–2797. 2015.PubMed/NCBI
14	Kang Y, Lee JM, Kim SH, Han JK and Choi BI: Intrahepatic mass-forming cholangiocarcinoma: Enhancement patterns on gadoxetic acid-enhanced MR Images. Radiology. 264:751–760. 2012. View Article : Google Scholar : PubMed/NCBI
15	Kim R, Lee JM, Shin CI, Lee ES, Yoon JH, Joo I, Kim SH, Hwang I, Han JK and Choi BI: Differentiation of intrahepatic mass-forming cholangiocarcinoma from hepatocellular carcinoma on gadoxetic acid-enhanced liver MR imaging. Eur Radiol. 26:1808–1817. 2016. View Article : Google Scholar : PubMed/NCBI
16	Maetani Y, Itoh K, Watanabe C, Shibata T, Ametani F, Yamabe H and Konishi J: MR imaging of intrahepatic cholangiocarcinoma with pathologic correlation. AJR Am J Roentgenol. 176:1499–1507. 2001. View Article : Google Scholar : PubMed/NCBI
17	Chung YE, Kim MJ, Park YN, Choi JY, Pyo JY, Kim YC, Cho HJ, Kim KA and Choi SY: Varying appearances of cholangiocarcinoma: Radiologic-pathologic correlation. Radiographics. 29:683–700. 2009. View Article : Google Scholar : PubMed/NCBI
18	Semelka RC, Martin DR, Balci C and Lance T: Focal liver lesions: Comparison of dual-phase CT and multisequence multiplanar MR imagingincluding dynamic gadolinium enhancement. J Magn Reson Imaging. 13:397–401. 2001. View Article : Google Scholar : PubMed/NCBI
19	Tsunematsu S, Chuma M, Kamiyama T, Miyamoto N, Yabusaki S, Hatanaka K, Mitsuhashi T, Kamachi H, Yokoo H, Kakisaka T, et al: Intratumoral artery on contrast-enhanced computed tomography imaging: Differentiating intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma. Abdom Imaging. 40:1492–1499. 2015. View Article : Google Scholar : PubMed/NCBI
20	Mosconi S, Beretta GD, Labianca R, Zampino MG, Gatta G and Heinemann V: Cholangiocarcinoma. Crit Rev Oncol Hematol. 69:259–270. 2009. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Contrast‑enhanced multiple‑phase imaging features of intrahepatic mass‑forming cholangiocarcinoma and hepatocellular carcinoma with cirrhosis: A comparative study

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