Dynamic enhancement pattern of intrahepatic cholangiocarcinoma on contrast-enhanced ultrasound: the correlation with cirrhosis and tumor size
Dynamic enhancement pattern of intrahepatic cholangiocarcinoma on contrast-enhanced ultrasound: the correlation with cirrhosis and tumor size
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DOI：
10.1007/s00261-015-0379-y
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发表时间：
2015-08-01
影响因子：
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通讯作者：
Li, Cui-Xian
中科院分区：
文献类型：
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作者：
Lu, Qing;Xue, Li-Yun;Li, Cui-Xian
回顾性评价不同大小、不同肝脏背景的肝内胆管癌（ICC）的超声造影动态增强模式。98例病理证实的ICCs （n = 39 < 30 mm, n = 59 < 30 mm, n = 45肝硬化，n = 53正常肝脏）行超声造影。回顾性分析超声造影的动态增强模式。在动脉期，非均匀性高强化在肝硬化的ICCs中更为常见（21/ 45,46.7%，正常肝的ICCs为11/ 53,20.8%,p = 0.009），而外周性高强化和低强化在正常肝的ICCs中更为常见（14/ 53,26.4%;11/ 53,20.8%，肝硬化的ICCs为2/ 45,4.4%;2/ 45,4.4%,p = 0.005和0.033）。门脉期与延迟期之间无显著差异。在< 30 mm的icc中，均匀性超强化更为常见（27/ 39,69.2% vs. 10/ 59,16.9%, bbb30 mm, p < 0.001），而在> 30 mm的icc中，不均匀性和周围性超强化更为常见（26/ 59,44.1% vs. 6/ 39,15.4%, p = 0.004, 14/ 59,23.7% vs. 2/ 39,5.1%, ICCs < 30 mm, p = 0.023）。不同尺寸的icc在门脉期和延迟期的冲蚀模式无显著差异。60.7% (17/28) < 30mm肝硬化患者和85.2% (23/27)bbb30 mm肝硬化患者以及66.7% (14/21)< 30mm正常肝患者在动脉期表现出强烈的造影剂摄取（均质或非均质超增强），随后出现门脉期和延迟期冲洗，远高于> 30 mm正常肝患者（34.4%,11/32,p < 0.001, < 0.001, =0.027）。超声造影显示ICC的动态增强模式随大小和肝脏背景不同而不同。在大多数合并肝硬化的icc和大多数< 30 mm的正常肝脏icc中，CEUS上的增强模式与肝细胞癌难以区分。
To retrospectively evaluate the dynamic enhancement pattern of contrast-enhanced ultrasound (CEUS) in intrahepatic cholangiocarcinoma (ICC) of varying sizes and hepatic backgrounds.CEUS was performed in 98 pathologically confirmed ICCs (n = 39 < 30 mm, n = 59 > 30 mm; n = 45 with cirrhosis and n = 53 with normal liver). The dynamic enhancement pattern of CEUS was retrospectively analyzed.In the arterial phase, heterogeneous hyper-enhancement was more frequent in ICCs with cirrhosis (21/45, 46.7% vs. 11/53, 20.8% in ICCs with normal liver, p = 0.009), while peripheral hyper-enhancement and hypo-enhancement were more common in ICCs with normal liver (14/53, 26.4%; 11/53, 20.8% vs. 2/45, 4.4%; 2/45, 4.4% in ICCs with cirrhosis, p = 0.005 and 0.033, respectively). There were no significant differences between portal and delayed phases. In ICCs < 30 mm, homogeneous hyper-enhancement was more frequently identified (27/39, 69.2% vs. 10/59, 16.9% in ICCs > 30 mm, p < 0.001), whereas in ICCs > 30 mm, heterogeneous, and peripheral hyper-enhancement were more commonly observed (26/59, 44.1% vs. 6/39, 15.4% in ICCs < 30 mm, p = 0.004, and 14/59, 23.7% vs. 2/39, 5.1% in ICCs < 30 mm, p = 0.023, respectively). The washout pattern in portal and delayed phases were not significantly different in ICCs with different sizes. 60.7% (17/28) ICCs < 30 mm and 85.2% (23/27) ICCs > 30 mm with cirrhosis, together with 66.7% (14/21) ICCs < 30 mm with normal liver displayed intense contrast agent uptake (homogeneous or heterogeneous hyper-enhancement) in arterial phase followed by washout in portal and delayed phase, which was much higher than that in ICCs > 30 mm with normal liver (34.4%, 11/32, p < 0.001, < 0.001 and =0.027, respectively).The CEUS dynamic enhancement pattern of ICC varies with size and hepatic background. The enhancement pattern is indistinguishable from hepatocellular carcinoma on CEUS in most ICCs with cirrhosis and in most ICCs < 30 mm with normal liver.