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MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers

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Abstract

Purpose

To compare MR imaging features of combined hepatocellular-cholangiocarcinoma (cHCC-CC) in normal, fibrotic, and cirrhotic livers.

Methods

A total of 64 patients with 67 pathologically proven cHCC-CCs were retrospectively analyzed. Patients were classified into three groups according to the patients’ liver condition: patients with normal liver (F0, group 1), fibrosis without cirrhosis (F1–3, group 2), and cirrhosis (F4, group 3). The morphological and MR signal features on T1- and T2-weighted, dynamic contrast-enhanced, diffusion-weighted imaging, as well as the accompanying imaging findings, were evaluated and compared.

Results

There were 12, 19, and 33 patients in groups 1, 2, and 3, respectively. Tumors in the fibrotic and cirrhotic livers were smaller than those in the normal liver, and tumors with cirrhosis had the smallest size (P = 0.0326). No statistical difference was found when comparing the signal intensity on T2-weighted imaging (P = 0.496), but iso- or hypointense lesions were only found in the fibrosis (n = 2) or cirrhosis group (n = 2). Enhancement pattern was different between groups, the washout pattern was more often seen in the cirrhosis group (P = 0.049), and the accompanying mosaic architecture was also more commonly seen in the cirrhosis group (P = 0.048). The ADC values of the lesions were not different among the three groups (P = 0.899).

Conclusion

MRI may provide valuable information for the diagnosis and differential diagnosis of cHCC-CC in normal, fibrotic, and cirrhotic livers. The nodule size, enhancement pattern, and the presence of mosaic architecture in cHCC-CC differ between different degrees of background liver disease.

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Acknowledgments

This study was funded by the National Natural Science Foundation of China (Grant Number 81571661), the Shanghai Sailing Program (Grant Number 16YF1410600), and the Youth Science Foundation of Zhongshan Hospital, Fudan University (Grant Number 2015ZSQN14).

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Authors and Affiliations

  1. Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Ruo Fan Sheng, Cai Zhong Chen, Li Yang, Kai Pu Jin & Meng Su Zeng

  2. Shanghai Institute of Medical Imaging, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Ruo Fan Sheng, Cai Zhong Chen, Li Yang, Kai Pu Jin & Meng Su Zeng

  3. Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China

    Yan Hong Xie & Yuan Ji

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  1. Ruo Fan Sheng
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Correspondence to Meng Su Zeng.

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Conflict of interest

Ruo Fan Sheng, Yan Hong Xie, Yuan Ji, Cai Zhong Chen, Li Yang, Kai Pu Jin, and Meng Su Zeng declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This retrospective study was approved by the institutional review board and informed consent was waived.

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Sheng, R.F., Xie, Y.H., Ji, Y. et al. MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers. Abdom Radiol 41, 2102–2114 (2016). https://doi.org/10.1007/s00261-016-0811-y

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  • DOI: https://doi.org/10.1007/s00261-016-0811-y

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