MRI of small intrahepatic mass-forming cholangiocarcinoma and atypical small hepatocellular carcinoma (≤3 cm) with cirrhosis and chronic viral hepatitis: a comparative study

Ruo-Fan Sheng; Meng-Su Zeng; Sheng-Xiang Rao; Yuan Ji; Ling-Li Chen

doi:10.1016/j.clinimag.2013.12.022

MRI of small intrahepatic mass-forming cholangiocarcinoma and atypical small hepatocellular carcinoma (≤3 cm) with cirrhosis and chronic viral hepatitis: a comparative study

Clin Imaging. 2014 May-Jun;38(3):265-72. doi: 10.1016/j.clinimag.2013.12.022. Epub 2014 Jan 13.

Authors

Ruo-Fan Sheng¹, Meng-Su Zeng², Sheng-Xiang Rao¹, Yuan Ji³, Ling-Li Chen³

Affiliations

¹ Department of Radiology, Zhongshan Hospital, Shanghai Medical School, Fudan, University, Shanghai Medical Imaging Institute, No. 180 Fenglin Road, Xuhui, District, Shanghai 200032, China.
² Department of Radiology, Zhongshan Hospital, Shanghai Medical School, Fudan, University, Shanghai Medical Imaging Institute, No. 180 Fenglin Road, Xuhui, District, Shanghai 200032, China. Electronic address: zengmengsu@gmail.com.
³ Department of Pathology, Zhongshan Hospital, Shanghai Medical School, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.

PMID: 24559750
DOI: 10.1016/j.clinimag.2013.12.022

Abstract

Objective: The objective was to identify the decision-making magnetic resonance (MR) features in differentiating small intrahepatic mass-forming cholangiocarcinoma (sIMCC) from atypical small hepatocellular carcinoma (sHCC) (≤3 cm) in patients with cirrhosis and chronic viral hepatitis.

Methods: Signal features and relative contrast of sHCCs and sIMCCs in T2-weighted and dynamic enhanced imaging were analyzed. A subgroup comparison between the cirrhosis and noncirrhosis chronic viral hepatitis group was also made.

Results: Univariate analysis revealed that tumor contours (P<.001), signals in T2-weighted (P<.001) and each phase of contrast-enhanced scanning (P<.001), enhancement patterns (P<.001), as well as accompanying findings of tumor capsule (P<.001), hepatic capsule retraction (P<.001), bile duct dilation (P=.031), and transient hepatic intensity difference (P=.002) were different between sIMCC and atypical sHCC. Multivariate analysis indicated that dynamic enhancement patterns (P<.001) and signals in T2-weighted images (P=.024) were independent predictors for differentiation. Confusing MR features were more often observed in the cirrhosis group compared with those in the noncirrhosis chronic viral hepatitis group.

Conclusion: Dynamic enhancement patterns and signals in T2-weighted images were the most important MR features to differentiate sIMCC from atypical sHCC with cirrhosis and chronic viral hepatitis.

Keywords: Cholangiocarcinoma; Hepatocellular carcinoma; Liver; Magnetic resonance imaging.

Publication types

Comparative Study

MeSH terms

Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms / diagnosis*
Bile Ducts, Intrahepatic
Carcinoma, Hepatocellular / diagnosis*
Cholangiocarcinoma / diagnosis*
Contrast Media
Diagnosis, Differential
Female
Hepatitis B, Chronic / diagnosis*
Hepatitis C, Chronic / diagnosis*
Humans
Image Enhancement / methods*
Liver Cirrhosis / diagnosis*
Liver Neoplasms / diagnosis*
Magnetic Resonance Imaging / methods*
Male
Middle Aged

Substances

Contrast Media