Intratumoral artery on contrast-enhanced computed tomography imaging: differentiating intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma

被引：34

作者：

Tsunematsu, Seiji ^{[1
]}

Chuma, Makoto ^{[1
,5
]}

Kamiyama, Toshiya ^{[2
]}

Miyamoto, Noriyuki ^{[3
]}

Yabusaki, Satoshi ^{[3
]}

Hatanaka, Kanako ^{[4
]}

Mitsuhashi, Tomoko ^{[4
]}

Kamachi, Hirofumi ^{[2
]}

Yokoo, Hideki ^{[2
]}

Kakisaka, Tatsuhiko ^{[2
]}

Tsuruga, Yousuke ^{[2
]}

Orimo, Tatsuya ^{[2
]}

Wakayama, Kenji ^{[2
]}

Ito, Jun ^{[1
]}

Sato, Fumiyuki ^{[1
]}

Terashita, Katsumi ^{[1
]}

Nakai, Masato ^{[1
]}

Tsukuda, Yoko ^{[1
]}

Sho, Takuya ^{[1
]}

Suda, Goki ^{[1
]}

Morikawa, Kenichi ^{[1
]}

Natsuizaka, Mitsuteru ^{[1
]}

Nakanishi, Mitsuru ^{[1
]}

Ogawa, Koji ^{[1
]}

Taketomi, Akinobu ^{[2
]}

Matsuno, Yoshihiro ^{[4
]}

Sakamoto, Naoya ^{[1
]}

机构：

[1] Hokkaido Univ, Grad Sch Med, Dept Gastroenterol & Hepatol, Kita Ku, Sapporo, Hokkaido 0608638, Japan

[2] Hokkaido Univ, Grad Sch Med, Dept Surg Gastroenterol, Sapporo, Hokkaido 0608638, Japan

[3] Hokkaido Univ, Grad Sch Med, Dept Diagnost & Intervent Radiol, Sapporo, Hokkaido 0608638, Japan

[4] Hokkaido Univ Hosp, Dept Surg Pathol, Sapporo, Hokkaido 060, Japan

[5] Yokohama City Univ, Med Ctr, Gastroenterol Ctr, Yokohama, Kanagawa 232, Japan

来源：

ABDOMINAL IMAGING | 2015年 / 40卷 / 06期

关键词：

Intrahepatic cholangiocarcinoma; Intratumoral artery; Poorly differentiated hepatocellular carcinoma; Contrast-enhanced CT; Differential diagnosis; PERIPHERAL CHOLANGIOCARCINOMA; GROWTH-PATTERN; MANAGEMENT; CT; LIVER; DIAGNOSIS; UPDATE;

D O I：

10.1007/s00261-015-0352-9

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Differentiating intrahepatic cholangiocarcinoma (ICC) from poorly differentiated hepatocellular carcinoma (p-HCC) is often difficult, but it is important for providing appropriate treatments. The purpose of this study was to examine the features differentiating ICC from p-HCC on contrast-enhanced dynamic-computed tomography (CT). This study examined 42 patients with pathologically confirmed ICC (n = 19) or p-HCC (n = 23) for which contrast-enhanced dynamic CT data were available. CT images were analyzed for enhancement patterns during the arterial phase, washout pattern, delayed enhancement, satellite nodules, capsular retraction, lesion shape, and presence of an intratumoral hepatic artery, intratumoral hepatic vein, intratumoral portal vein, and bile duct dilation around the tumor, portal vein tumor thrombus, lobar atrophy, or lymphadenopathy. Univariate analysis revealed the presence of rim enhancement (p = 0.037), lobulated shape (p = 0.004), intratumoral artery (p < 0.001), and bile duct dilation (p = 0.006) as parameters significantly favoring ICC, while a washout pattern significantly favored p-HCC (p < 0.001). Multivariate analysis revealed intratumoral artery as a significant, independent variable predictive of ICC (p = 0.037), and 15 ICCs (78.9%) showed this feature. Washout pattern was a significant, independent variable favoring p-HCC (p = 0.049), with 15 p-HCCs (65.2%) showing this feature. The presence of an intratumoral artery in the arterial phase on contrast-enhanced dynamic CT was a predictable finding for ICC, and the presence of a washout pattern was a predictable finding for p-HCC, differentiating between ICC and p-HCC.

引用

页码：1492 / 1499

页数：8

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