Mass-forming intrahepatic cholangiocarcinoma: Enhancement patterns in the arterial phase of dynamic hepatic CT - Correlation with clinicopathological findings
Mass-forming intrahepatic cholangiocarcinoma: Enhancement patterns in the arterial phase of dynamic hepatic CT - Correlation with clinicopathological findings
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DOI：
10.1007/s00330-016-4386-3
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发表时间：
2017-02-01
影响因子：
5.9
通讯作者：
Honda, Hiroshi
中科院分区：
文献类型：
--
作者：
Fujita, Nobuhiro;Asayama, Yoshiki;Honda, Hiroshi
为探讨肝内胆管细胞癌（ICC）肝动脉期（HAP）动态增强模式与临床病理特征的关系，特别是肝门周围型和周围型ICC的动态增强模式。根据HAP的增强模式，将病灶分为三组：少血管组（n=13），边缘增强组（n=18）和多血管组（n=16）。比较三组间的临床病理学表现，低血供组中门周型ICC的发生率明显高于边缘强化组和血供丰富组（分别为p=0.006和p < 0.001）。低血运组的淋巴管浸润、神经周围浸润和胆道浸润明显高于边缘增强组（分别为p=0.001、p=0.025和p=0.029）或高血运组（分别为p < 0.001、p < 0.001和p=0.025）。低血管病变患者的无病生存率显著低于边缘增强或高血管病变患者（分别为p=0.001和p=0.001）。血供减少是无病生存的独立术前预后因素（p < 0.001）。HAP中的低血供ICC倾向于门周型，比其他ICC具有更高的恶性潜能。型ICC并不总是显示远端导管壁增厚。
To evaluate the relationship between the enhancement pattern of intrahepatic cholangiocarcinomas (ICCs) in the hepatic arterial phase (HAP) of dynamic hepatic CT and the clinicopathological findings with special reference to the perihilar type and the peripheral type.Forty-seven patients with pathologically proven ICCs were enrolled. Based on the enhancement pattern in the HAP, the lesions were classified into three groups: a hypovascular group (n=13), rim-enhancement group (n=18), and hypervascular group (n=16). The clinicopathological findings were compared among the three groups.Perihilar-type ICCs were significantly more frequently observed in the hypovascular group than in the rim-enhancement and hypervascular groups (p=0.006 and p < 0.001, respectively). Lymphatic invasion, perineural invasion, and biliary invasion were significantly more frequent in the hypovascular group than the rim- enhancement group (p=0.001, p=0.025 and p=0.029, respectively) or hypervascular group (p < 0.001, p < 0.001 and p=0.025, respectively). Patients with hypovascular lesions showed significantly poorer disease-free survival than patients with rim-enhancing or hypervascular lesions (p=0.001 and p=0.001, respectively). Hypovascularity was an independent preoperative prognostic factor for disease-free survival (p < 0.001).Hypovascular ICCs in the HAP tend to be of perihilar type and to have more malignant potential than other ICCs.aEuro cent Hypovascular ICCs have greater malignant potential than rim-enhancing and hypervascular ICCs.aEuro cent Hypovascular ICCs show a higher frequency of perihilar-type ICCs.aEuro cent Perihilar-type ICCs do not always display distal ductal wall thickening.