Kim Na Ra, Lee Jeong Min, Kim Se Hyung, An Su Kyung, Han Chang Jin, Choi Seung Hong, Han Joon Koo, Lee Hye Seung, Jang Ja Jun, Choi Byung Ihn
Department of Radiology, and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Clin Imaging. 2008 Mar-Apr;32(2):114-20. doi: 10.1016/j.clinimag.2007.08.022.
The purpose of this study was to characterize the differences in CT enhancement pattern among the morphologic subtypes of cholangiocarcinomas.
Unenhanced, hepatic arterial (HAP), and portal venous phase (PVP) CT images of 84 patients with pathologically proven cholangiocarcinoma were retrospectively reviewed. Tumors were of the following types: 27 mass-forming, 39 periductal-infiltrating, and 18 intraductal. The CT attenuation values of tumors were measured at each phase. The tumor enhancement ratio (ER) on HAP and PVP was calculated.
Each cholangiocarcinoma subtype produced characteristic enhancement relative to liver on HAP and PVP images: mass-forming tumors demonstrated hyperenhancing periphery and hyopenhancing centers; periductal-infiltrating tumors, hyperenhancing; and intraductal tumors, hypoenhancing. The ER of the tumor types was significantly different (P<.001, HAP, PVP): periductal-infiltrating tumors showed the highest ER (2.5; 3.8); the centers of mass-forming tumors, lowest (1.5; 2.2); the peripheries of mass-forming tumors, high (2.1; 3.0); intraductal tumors, low (1.9; 2.6).
Cholangiocarcinoma subtypes tended to exhibit distinct enhancement characteristics. Knowledge of these enhancement patterns may aid diagnosis and surgical planning.
本研究旨在描述胆管癌形态学亚型之间CT增强模式的差异。
回顾性分析84例经病理证实的胆管癌患者的平扫、肝动脉期（HAP）和门静脉期（PVP）CT图像。肿瘤类型如下：27例肿块型、39例胆管周围浸润型和18例导管内型。在每个阶段测量肿瘤的CT衰减值。计算HAP和PVP上的肿瘤增强率（ER）。
在HAP和PVP图像上，各胆管癌亚型相对于肝脏均呈现出特征性增强：肿块型肿瘤表现为周边强化、中心强化减低；胆管周围浸润型肿瘤，强化明显；导管内型肿瘤，强化减低。各肿瘤类型的ER有显著差异（P<0.001，HAP、PVP）：胆管周围浸润型肿瘤的ER最高（2.5；3.8）；肿块型肿瘤的中心，最低（1.5；2.2）；肿块型肿瘤的周边，较高（2.1；3.0）；导管内型肿瘤，较低（1.9；2.6）。
胆管癌亚型倾向于表现出不同的增强特征。了解这些增强模式可能有助于诊断和手术规划。
