Peripheral cholangiocarcinoma: comparison of MRI with CT

Abstract

To evaluate the clinical utility of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of peripheral cholangiocarcinoma of the liver, 11 patients with pathologically proven peripheral cholangiocarcinoma were examined with both CT and MRI. On CT scans in 10 cases, the tumors appeared as irregular, low-attenuation masses with a wide variation in heterogeneity. Contrast enhancement of the tumors was mild in nine cases and moderate in one case, at the periphery. Tumor was not identified in one case. On T1-weighted MRIs, the tumors showed low intensity in eight cases and isointensity in three cases. On T2-weighted images, the tumors showed high intensity in all 11 cases. Focal dilatation of the intrahepatic bile ducts around the tumor was seen in one case on MRIs and in four cases on CT scans. Portal vein invasion of the tumors was seen in one case, and lymphadenopathy was seen in four cases on both MRIs and CT scans. MRI was slightly superior to CT in detecting the tumors, was inferior to CT in delineating focal ductal dilatation around the tumors, and was equal to CT in assessing extent of the tumors.

CT Differentiation of Cholangiocarcinoma from Periductal Fibrosis in Patients with Hepatolithiasis

“…This finding agrees with a previous study regarding cholangiocarcinoma in which periductal infiltrating intrahepatic cholangiocarcinoma appeared as a periductal soft-tissue density or a focal ductal wall thickening on enhanced CT, usually showing early or late enhancement or both [13,16]. There were two cases of benign biliary stricture (12.5%, 2/16), which appeared as periductal low-attenuated soft-tissue-density lesions similar to malignant strictures in their enhancement pattern and were pathologically proven to be periductal fibrosis.…”

“…Typical CT findings of cholangiocarcinoma are parenchymal low-attenuated mass with rim enhancement, capsular retraction and delayed enhancement, biliary duct wall thickening, or intraductal polypoid mass with dilatation of upstream ducts [13][14][15][16]. However, only a few reports describe the radiologic findings of cholangiocarcinoma occurring in patients with hepatolithiasis [17][18][19].…”

Incidence of primary cholangiocellular carcinoma of the liver in Japanese patients with hepatitis C virus-related cirrhosis

“…The diagnostic criterion of PCC-L included dilation of the intrahepatic bile duct, as described previously. [27][28][29][30][31][32][33] …”

New Imaging Techniques in the Evaluation of Gastrointestinal Diseases

“…Cholangiocarcinoma: Although cholangiocarcinoma can usually be diagnosed using ultrasonography or CT, conventional MRI permits better detection and delineation of intrahepatic tumour extension than do contrast-enhanced CT images (44). The assessment of tumour extension along the bile ducts generally requires direct cholangiography.…”