Department of Medical Ultrasound, Tenth People's Hospital of Tongji University & Shanghai Tenth People's Hospital, Medical Imaging Center of Tongji University, Shanghai, China.
Br J Radiol. 2012 Aug;85(1016):1029-37. doi: 10.1259/bjr/21653786. Epub 2012 Feb 28.
To investigate the correlation between enhancement patterns of intrahepatic cholangiocarcinoma (ICC) on contrast-enhanced ultrasound (CEUS) and pathological findings.
The CEUS enhancement patterns of 40 pathologically proven ICC lesions were retrospectively analysed. Pathologically, the degree of tumour cell and fibrosis distribution in the lesion was semi-quantitatively evaluated.
4 enhancement patterns were observed in the arterial phase for 32 mass-forming ICCs: peripheral rim-like hyperenhancement (n=19); heterogeneous hyperenhancement (n=6); homogeneous hyperenhancement (n=3); and heterogeneous hypo-enhancement (n=4). Among the four enhancement patterns, the differences in tumour cell distribution were statistically significant (p<0.05). The hyperenhancing area on CEUS corresponded to more tumour cells for mass-forming ICCs. Heterogeneous hyperenhancement (n=2) and heterogeneous hypo-enhancement (n=2) were observed in the arterial phase for four periductal infiltrating ICCs. In this subtype, fibrosis was more commonly found in the lesions. Heterogeneous hyperenhancement (n=1) and homogeneous hyperenhancement (n=3) were observed in the arterial phase for four intraductal growing ICCs. This subtype tended to have abundant tumour cells.
The CEUS findings of ICC relate to the degree of carcinoma cell proliferation at pathological examination. Hyperenhancing areas in the tumour always indicated increased density of cancer cells.
探讨肝内胆管癌（ICC）在超声造影（CEUS）增强模式与病理表现之间的相关性。
回顾性分析 40 例经病理证实的 ICC 病变的 CEUS 增强模式。病理上，对病变中肿瘤细胞和纤维化分布程度进行半定量评估。
32 例肿块型 ICC 在动脉期观察到 4 种增强模式：周边环形高增强（n=19）；不均匀高增强（n=6）；均匀高增强（n=3）；不均匀低增强（n=4）。在这四种增强模式中，肿瘤细胞分布的差异具有统计学意义（p<0.05）。CEUS 上的高增强区域对应于更多的肿瘤细胞。4 例沿胆管浸润型 ICC 在动脉期呈不均匀高增强（n=2）和不均匀低增强（n=2）。在这种亚型中，病变中更常见纤维化。4 例沿胆管生长型 ICC 在动脉期呈不均匀高增强（n=1）和均匀高增强（n=3）。该亚型倾向于具有丰富的肿瘤细胞。
ICC 的 CEUS 表现与病理检查中癌细胞增殖程度有关。肿瘤的高增强区域总是提示癌细胞密度增加。
