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

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
Published online on: July 24, 2017 https://doi.org/10.3892/ol.2017.6656
Pages: 4213-4219
Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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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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