Typical and atypical imaging findings of intrahepatic cholangiocarcinoma using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging

So Hee Kim, Chang Hee Lee, Baek Hui Kim, Wan Bae Kim, Suk Keu Yeom, Kyeong Ah Kim, Cheol Min Park

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    40 Citations (Scopus)

    Abstract

    Purpose: The objective of this study was to examine the imaging features of classic mass-forming intrahepatic cholangiocarcinoma (MICC) and nonclassic hypervascular MICC on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging. Methods: Twenty pathologically confirmed MICCs were included. Two radiologists retrospectively reviewed the imaging characteristics on T2-weighted imaging, diffusion-weighted imaging, dynamic contrast-enhanced images, and hepatobiliary phase (HBP) of each MICC. For the morphologic feature of defect, HBP signal intensity (SI) ratio was calculated by dividing the SI of the MICC by nearby normal liver parenchyma SI. Results: Classic MICCs (n = 14) showed classic rim or peripheral enhancement at arterial dominant phase with centripetal enhance in the delayed phases. Hypervascular MICCs (n = 6) showed complete (n = 4) or near-complete (n = 2) arterial enhancement and washout (n = 6) on delayed phases. On HBP, 13 classic MICCs (93%) and 2 hypervascular MICCs (33%) showed cloud-like SI in the center ("EOB cloud") with peripheral defect. Mean SI ratio was 0.77 in classic MICCs and 0.59 in hypervascular MICC (P = 0.057). Conclusions: Classic MICCs (70%) frequently showed progressive centripetal enhancement on dynamic phase, and central EOB-cloud appearance with distinct peripheral defect on HBP. Nonclassic hypervascular MICCs comprised 30% of the MICCs in this study. Compared with classic MICCs, hypervascular MICCs showed wash-in on arterial dominant phase and washout on delayed phase.

    Original languageEnglish
    Pages (from-to)704-709
    Number of pages6
    JournalJournal of Computer Assisted Tomography
    Volume36
    Issue number6
    DOIs
    Publication statusPublished - 2012 Nov

    Keywords

    • Cholangiocarcinoma
    • Gadoxetic acid
    • Gd-EOB-DTPA
    • Liver
    • MRI

    ASJC Scopus subject areas

    • Radiology Nuclear Medicine and imaging

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