Kim Young Kon, Han Young Min, Kim Chong Soo
Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, South Korea.
Eur J Radiol. 2009 Apr;70(1):94-100. doi: 10.1016/j.ejrad.2008.01.015. Epub 2008 Mar 7.
The purpose of this study was to compare MRI findings of diffuse hepatocellular carcinoma (D-HCC) and intrahepatic cholangiocarcinoma (IHC) to identify characteristics of each.
We retrospectively analyzed MRI that consisted of unenhanced T1- and T2-weighted image, gadolinium (Gd)-enhanced dynamic image, and sequentially acquired Resovist-enhanced image from 29 patients with D-HCCs and 32 patients with IHC.
On T2-weighted imaging, D-HCCs usually appeared as poorly defined, infiltrative mildly hyperintense masses, whereas IHC appeared as well-defined, lobulated mildly hyperintense masses with areas of strong hyperintensity and hypointensity. On dynamic- and Resovist-enhanced T1-weighted MRIs, D-HCCs appeared as hypovascular and homogeneously hypointense or isointense masses with internal reticulation, whereas IHD appeared as centripetal enhancing masses with or without delayed central hyperintensity. Biliary dilatation was predominantly observed in the area adjacent to the IHC and in the intratumoral area of D-HCC. Portal venous tumor thrombus was observed in most of the D-HCC, and portal vein encasement was seen in 17 of the IHC.
D-HCC and IHC exhibited characteristics of each at T1- and T2-weighted imaging, Gd-enhanced dynamic imaging, and sequentially acquired Resovist-enhanced T1-weighted imaging.
本研究旨在比较弥漫性肝细胞癌（D-HCC）和肝内胆管癌（IHC）的MRI表现，以明确各自的特征。
我们回顾性分析了29例D-HCC患者和32例IHC患者的MRI，包括未增强的T1加权和T2加权图像、钆（Gd）增强动态图像以及顺序采集的Resovist增强图像。
在T2加权成像上，D-HCC通常表现为边界不清、浸润性的轻度高信号肿块，而IHC表现为边界清晰、分叶状的轻度高信号肿块，伴有高信号和低信号区域。在动态和Resovist增强的T1加权MRI上，D-HCC表现为低血供、均匀低信号或等信号肿块，内部有网状结构，而IHD表现为向心性强化肿块，有或无延迟的中心高信号。胆管扩张主要见于IHC附近区域和D-HCC的瘤内区域。大多数D-HCC可见门静脉瘤栓，17例IHC可见门静脉包绕。
D-HCC和IHC在T1加权和T2加权成像、Gd增强动态成像以及顺序采集的Resovist增强T1加权成像上均表现出各自的特征。
