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European Radiology

, Volume 27, Issue 2, pp 498–506 | Cite as

Mass-forming intrahepatic cholangiocarcinoma: Enhancement patterns in the arterial phase of dynamic hepatic CT - Correlation with clinicopathological findings

  • Nobuhiro Fujita
  • Yoshiki Asayama
  • Akihiro Nishie
  • Kousei Ishigami
  • Yasuhiro Ushijima
  • Yukihisa Takayama
  • Daisuke Okamoto
  • Koichiro Moirta
  • Ken Shirabe
  • Shinichi Aishima
  • Huanlin Wang
  • Yoshinao Oda
  • Hiroshi Honda
Gastrointestinal

Abstract

Objectives

To evaluate the relationship between the enhancement pattern of intrahepatic cholangiocarcinomas (ICCs) in the hepatic arterial phase (HAP) of dynamic hepatic CT and the clinicopathological findings with special reference to the perihilar type and the peripheral type.

Methods

Forty-seven patients with pathologically proven ICCs were enrolled. Based on the enhancement pattern in the HAP, the lesions were classified into three groups: a hypovascular group (n=13), rim-enhancement group (n=18), and hypervascular group (n=16). The clinicopathological findings were compared among the three groups.

Results

Perihilar-type ICCs were significantly more frequently observed in the hypovascular group than in the rim-enhancement and hypervascular groups (p=0.006 and p <0.001, respectively). Lymphatic invasion, perineural invasion, and biliary invasion were significantly more frequent in the hypovascular group than the rim- enhancement group (p=0.001, p=0.025 and p=0.029, respectively) or hypervascular group (p <0.001, p <0.001 and p=0.025, respectively). Patients with hypovascular lesions showed significantly poorer disease-free survival than patients with rim-enhancing or hypervascular lesions (p=0.001 and p=0.001, respectively). Hypovascularity was an independent preoperative prognostic factor for disease-free survival (p<0.001).

Conclusions

Hypovascular ICCs in the HAP tend to be of perihilar type and to have more malignant potential than other ICCs.

Key Points

Hypovascular ICCs have greater malignant potential than rim-enhancing and hypervascular ICCs.

Hypovascular ICCs show a higher frequency of perihilar-type ICCs.

Perihilar-type ICCs do not always display distal ductal wall thickening.

Keywords

Intrahepatic cholangiocarcinoma Perihilar cholangiocarcinoma Peripheral cholangiocarcinoma Computed tomography Arterial enhancement pattern 

Abbreviations

ICC

intrahepatic cholangiocarcinoma

HAP

hepatic arterial phase

MDCT

multidetector computed tomography

Notes

Acknowledgments

We thank Dr. Yoshihiko Maehara, Department of Surgery and Science, Kyushu University, for providing the clinical information for this manuscript. This work was supported by a Grant-in-in-Aid for Scientific Research (C) (25461834) and (26461796) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology. The scientific guarantor of this publication is Professor Hiroshi Honda. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. No complex statistical methods were necessary for this paper.

Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Study subjects or cohorts have not been previously reported.

Methodology: retrospective, diagnostic or prognostic study / observational, performed at one institution.

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Nobuhiro Fujita
    • 1
  • Yoshiki Asayama
    • 1
  • Akihiro Nishie
    • 1
  • Kousei Ishigami
    • 1
  • Yasuhiro Ushijima
    • 1
  • Yukihisa Takayama
    • 2
  • Daisuke Okamoto
    • 1
  • Koichiro Moirta
    • 1
  • Ken Shirabe
    • 3
  • Shinichi Aishima
    • 4
  • Huanlin Wang
    • 5
  • Yoshinao Oda
    • 5
  • Hiroshi Honda
    • 1
  1. 1.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan
  2. 2.Department of Radiology Informatics and Network, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan
  3. 3.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan
  4. 4.Department of Pathology and Microbiology, Faculty of MedicineSaga University HospitalSaga CityJapan
  5. 5.Department of Anatomic Pathology, Graduate School of Medical SciencesKyushu UniversityHigashi-kuJapan

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