Differentiating Combined Hepatocellular and Cholangioc cinoma from Mass-Forming Intrahepatic Chol gioc cinoma Using Gadoxetic Acid-Enh ced MRI
Differentiating Combined Hepatocellular and Cholangioc cinoma from Mass-Forming Intrahepatic Chol gioc cinoma Using Gadoxetic Acid-Enh ced MRI
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DOI：
10.1002/jmri.23728
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发表时间：
2012-10-01
影响因子：
4.4
通讯作者：
Rhim, Hyun Chul
中科院分区：
文献类型：
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作者：
Hwang, Jiyoung;Kim, Young Kon;Rhim, Hyun Chul
目的探讨钆塞酸增强MRI对肝细胞和胆管细胞癌（HCC-CC）与肿块形成型肝内胆管细胞癌（ICC）的鉴别特征。材料与方法40例经病理证实的HCC-CC（n = 20）和ICC（n = 20）患者接受钆塞酸增强MRI检查。分析MR图像中病变的形状、T2加权图像（T2 WI）上的低或高信号区域、早期动态期的边缘增强以及10分钟和20分钟肝胆期（HBP）的中心增强伴低信号边缘（靶外观）。结果形态不规则、动态增强早期边缘强化强、无靶区出现的HBP有利于HCC-CC合并症的发生（P<0. 05）。分叶状、弱周边边缘强化以及10 min和20 min HBP上存在完整靶区有利于ICC（P< 0.05）。然而，10例以CC为主的混合型HCC-CC在10分钟HBP时显示出完全或部分靶区外观。结论肿瘤的形状、早期动态阶段的边缘增强程度以及HBP上的靶区外观对于区分混合型HCC-CC和钆酸增强MRI上的团块状ICC很有价值。J.磁共振Imaging 2012;36：881-889.© 2012 Wiley Periodicals，Inc.
PurposeTo examine the differential features of combined hepatocellular and cholangiocarcinoma (HCC‐CC) from mass‐forming intrahepatic cholangiocarcinoma (ICC) on gadoxetic acid‐enhanced MRI.Materials and MethodsForty patients with pathologically proven combined HCC‐CC (n = 20) and ICCs (n = 20) who had undergone gadoxetic acid‐enhanced MRI were enrolled in this study. MR images were analyzed for the shape of lesions, hypo‐ or hyperintense areas on the T2‐weighted image (T2WI), rim enhancement during early dynamic phases, and central enhancement with hypointense rim (target appearance) on the 10‐min and 20‐min hepatobiliary phase (HBP). The significance of these findings was determined by the χ2test.ResultsIrregular shape and strong rim enhancement during early dynamic phases, and absence of target appearance on HBP favored combined HCC‐CCs (P< 0.05). Lobulated shape, weak peripheral rim enhancement, and the presence of complete target appearance on the 10‐min and 20‐min HBP favored ICCs (P< 0.05). However, 10 CC‐predominant type of combined HCC‐CC showed complete or partial target appearance on 10‐min HBP.ConclusionThe shape of tumors, degree of rim enhancement during early dynamic phases, and target appearance on HBP were valuable for differentiating between combined HCC‐CC and mass‐forming ICC on gadoxetic acid‐enhanced MRI. J. Magn. Reson. Imaging 2012;36:881–889. © 2012 Wiley Periodicals, Inc.