Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2016 May 26:6:26772.
doi: 10.1038/srep26772.

Dynamic enhancement patterns of intrahepatic cholangiocarcinoma in cirrhosis on contrast-enhanced computed tomography: risk of misdiagnosis as hepatocellular carcinoma

Rui Li  1 , Ping Cai  2 , Kuan-Sheng Ma  1 , Shi-Yi Ding  2 , De-Yu Guo  3 , Xiao-Chu Yan  3
Affiliations
Comparative Study

Dynamic enhancement patterns of intrahepatic cholangiocarcinoma in cirrhosis on contrast-enhanced computed tomography: risk of misdiagnosis as hepatocellular carcinoma

Rui Li et al. Sci Rep. .

Abstract

This study aimed to assess the features of intrahepatic cholangiocarcinoma (ICC) at computerized tomography (CT) and verify the risk of misdiagnosis of ICC as hepatocellular carcinoma (HCC) in cirrhosis. CT appearances of 98 histologically confirmed ICC nodules from 84 cirrhotic patients were retrospectively reviewed, taking into consideration the pattern and dynamic contrast uptake during the arterial, portal venous and delayed phases. During the arterial phase, 53 nodules (54.1%) showed peripheral rim-like enhancement, 35 (35.7%) hyperenhancement, 9 (9.2%) hypoenhancement and 1 (1.0%) isoenhancement. The ICC nodules showed heterogeneous dynamic contrast patterns, being progressive enhancement in 35 nodules (35.7%), stable enhancement in 28 nodules (28.6%), wash-in and wash-out pattern in 15 nodules (15.3%) and all other enhancement patterns in 20 nodules (20.4%). There were no significant differences in the dynamic vascular patterns of ICC according to nodule size (p > 0.05). ICC in cirrhosis has varied enhancement patterns at contrast-enhanced multiphase multidetector CT. Though the majority of ICC did not display typical radiological hallmarks of HCC, if dynamic CT scan was used as the sole modality for the non-invasive diagnosis of nodules in cirrhosis, the risk of misdiagnosis of ICC for HCC is not negligible.

PubMed Disclaimer

Figures

Figure 1
Figure 1. tif CT images of a 32-year-old man with a 4.2-cm –diameter ICC displaying stable contrast enhancement pattern.
(a) unenhanced, (b) Arterial, (c) portal, and (d) delayed phases. After intravenous contrast administration, the nodule shows stable peripheral rim-like enhancement (arrow).
Figure 2
Figure 2. tif CT images of a 75-year-old man with a 3.8-cm –diameter ICC displaying progressive contrast enhancement pattern.
(a) unenhanced, (b) Arterial, (c) portal, and (d) delayed phases. After intravenous contrast administration, the nodule shows progressive centripetal enhancement (arrow).
Figure 3
Figure 3. tif CT images of a 69-year-old woman with a 2.7-cm –diameter ICC displaying wash-in and wash-out enhancement pattern.
The nodule was hypodense at unenhanced CT (a). After intravenous contrast administration, the nodule shows marked hyper-enhancement during the arterial phase (b) followed by wash-out during the portal phase (c) and the late phase (d) (arrow).
See this image and copyright information in PMC

References

    1. Patel T. Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States. Hepatology. 33, 1353–1357 (2001). - PubMed
    1. Khan S. A. et al.. Changing international trends in mortality rates for liver, biliary and pancreatic tumours. J Hepatol. 37, 806–813 (2002). - PubMed
    1. Khan S. A., Thomas H. C., Davidson B. R. & Taylor-Robinson S. D. Cholangiocarcinoma. Lancet. 366, 1303–1314 (2005). - PubMed
    1. Shaib Y. & El-Serag H. B. The epidemiology of cholangiocarcinoma. Semin Liver Dis. 24, 115–125 (2004). - PubMed
    1. Shaib Y. H., El-Serag H. B., Davila J. A., Morgan R. & McGlynn K. A. Risk factors of intrahepatic cholangiocarcinoma in the United States: a case-control study. Gastroenterology. 128, 620–626 (2005). - PubMed

Publication types

MeSH terms