Abdominal Radiology

, Volume 37, Issue 5, pp 767–774 | Cite as

Malignant versus benign hepatic masses in patients with recurrent pyogenic cholangitis: MR differential diagnosis

  • Hyo Won Eun
  • Jung Hoon KimEmail author
  • Seong Sook Hong
  • Young Jae Kim



To assess MR findings and diagnostic performance for differentiating malignant from benign hepatic masses in recurrent pyogenic cholangitis (RPC).

Materials and methods

During a recent 6-year period, we performed MRI in 352 patients with RPC. Among them, 58 had confirmed hepatic masses; cholangiocarcinoma (n = 15), abscess (n = 37), inflammatory pseudotumor (n = 3), biloma (n = 3). Two radiologists assessed MR findings including enhancement patterns, intratumoral appearance, peritumoral changes, mass location, and multiplicity. They also graded the malignancy using common MR findings. The receiver operating characteristic analysis and Chi-square test were used. The κ statistics was used to determine interobserver agreement.


The common findings for cholangiocarcinoma were thin and lobulated enhancement at the periphery (n = 8, 53%, P < 0.05); ill-defined enhancement (n = 7, 47%, P < 0.05); slightly high signal on T2 (n = 13, 87%, P < 0.05); mass located in the same lobe of atrophy (n = 11, 73%, P < 0.05) and portal vein thrombosis (n = 15, 100%, P < 0.05). The common findings for benign mass were target-like enhancement (n = 36, 84%, P < 0.05); cluster appearance (n = 15, 35%, P < 0.05); central, fluid-like space (n = 29, 67%, P < 0.05); peritumoral regional high signal on T2 (n = 32, 74%, P < 0.05); multiplicity(n = 21, 49%, P < 0.05). Interobserver agreement was excellent (κ = 0.81–1.000). Area under the curve (Az) for differentiating malignant masses was 0.989, sensitivity was 95.3%, and specificity was 95.3%. There was good interobserver agreement (κ = 0.74).


MR imaging is very useful for differential diagnosis of malignant vs. benign hepatic masses in patients with RPC.


Biliary system Pyogenic cholangitis Cancer Cholangiocarcinoma Abscess MRI 



We would like to thank Bonnie Hami, MA (USA) for her editorial assistance in the preparation of the manuscript.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Hyo Won Eun
    • 1
  • Jung Hoon Kim
    • 2
    Email author
  • Seong Sook Hong
    • 3
  • Young Jae Kim
    • 3
  1. 1.Health Promotion Center, Asan Medical CenterUniversity of UlsanSeoulSouth Korea
  2. 2.Department of Radiology and Institute of Radiation MedicineSeoul National University College of MedicineSeoulSouth Korea
  3. 3.Department of RadiologySoonchunhyang University HospitalSeoulSouth Korea

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