Hilar cholangiocarcinoma: comparative study with sonography and CT.

Abstract

Fifty-one patients were studied to determine the relative accuracy of sonography and computed tomography (CT) in the evaluation of hilar cholangiocarcinoma. Both sonography and CT permitted detection of intrahepatic bile duct dilatation in all patients. Nonunion of right and left intrahepatic bile ducts was identified with sonography in 90% and with CT in 94% of patients. The tumor per se was depicted by sonography in 21% and by CT in 40% of patients. Forty tumors (78%) were of the infiltrating type, seven (14%) were exophytic, and four (8%) were polypoid. With sonography, infiltrating and exophytic tumors were difficult to depict, whereas polypoid tumors were well identified. With CT, infiltrating tumors were more difficult to depict than were exophytic or polypoid tumors. On CT scans, depicted tumors of the infiltrating type showed high attenuation and an indistinct margin, whereas exophytic and polypoid tumors showed low attenuation and a well-defined margin. Sonography and CT were comparably accurate in determining the level of obstruction in hilar cholangiocarcinoma even when no mass was depicted. CT was superior to sonography in depicting tumor per se and in demonstrating associated findings.

Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma.

“…All exophytic hilar cholangiocarcinomas were hypodenseto liver on hepatic artery dominant phase and portal vein dominant phase scans.These fIndings are similar to those reported for hilar and peripheral cholan giocarcinomas [10,14,22,23]. These tumors were notably larger than the infiltrating stenotic tumors, probably because they grow intrahepatically.…”

CT of hilar cholangiocarcinoma: late contrast enhancement in six patients.

“…A protruding small low-density area is also shown ( that only 40% of HCs were detected and six (43%) of them were high-density masses on conventional CT scans [7]. If they had used late enhanced CT, the frequency of high-density masses would have been higher.…”

Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

“…Most hilar and extrahepatic cholangiocarcinomas are infiltrative, causing a focal stricture of the bile duct, whereas papillary carcinoma is occasionally found in the form of an intraductal polypoid mass (13,32,95,116). By thin-section computed tomography, the tumor tissue of the infiltrative type can be detected as an ill-defined focal wall thickening, usually with early or late enhancement or both (13,33).…”

“…By thin-section computed tomography, the tumor tissue of the infiltrative type can be detected as an ill-defined focal wall thickening, usually with early or late enhancement or both (13,33). By ultrasonography, the tumor can appear as a mural thickening or as an encircling mass along the bile duct wall (95).…”

“…By ultrasonography, the tumor can appear as a mural thickening or as an encircling mass along the bile duct wall (95). However, in many cases, the infiltrating tumor is frequently seen by either ultrasonography or computed tomography as nonunion of the dilated right and left hepatic ducts without an identifiable mass (13,104). Cholangiography shows a focal or diffuse stricture or complete obstruction of the bile ducts and thus allows the extent of the disease to be determined (22,104,116) (Fig.…”