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

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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 1

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Pentetic Acid
Cholangiocarcinoma
Gadolinium
Magnetic Resonance Imaging
Liver

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Typical and atypical imaging findings of intrahepatic cholangiocarcinoma using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging",
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.",
keywords = "Cholangiocarcinoma, Gadoxetic acid, Gd-EOB-DTPA, Liver, MRI",
author = "Kim, {So Hee} and Chang-Hee Lee and Baek-Hui Kim and Wan-Bae Kim and Yeom, {Suk Keu} and Kim, {Kyeong Ah} and Park, {Cheol Min}",
year = "2012",
month = "11",
day = "1",
doi = "10.1097/RCT.0b013e3182706562",
language = "English",
volume = "36",
pages = "704--709",
journal = "Journal of Computer Assisted Tomography",
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TY - JOUR

T1 - Typical and atypical imaging findings of intrahepatic cholangiocarcinoma using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging

AU - Kim, So Hee

AU - Lee, Chang-Hee

AU - Kim, Baek-Hui

AU - Kim, Wan-Bae

AU - Yeom, Suk Keu

AU - Kim, Kyeong Ah

AU - Park, Cheol Min

PY - 2012/11/1

Y1 - 2012/11/1

N2 - 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.

AB - 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.

KW - Cholangiocarcinoma

KW - Gadoxetic acid

KW - Gd-EOB-DTPA

KW - Liver

KW - MRI

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U2 - 10.1097/RCT.0b013e3182706562

DO - 10.1097/RCT.0b013e3182706562

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VL - 36

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EP - 709

JO - Journal of Computer Assisted Tomography

JF - Journal of Computer Assisted Tomography

SN - 0363-8715

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