Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Magn Reson Imaging. 2012 Oct;36(4):881-9. doi: 10.1002/jmri.23728. Epub 2012 Jun 21.
To examine the differential features of combined hepatocellular and cholangiocarcinoma (HCC-CC) from mass-forming intrahepatic cholangiocarcinoma (ICC) on gadoxetic acid-enhanced MRI.
Forty patients with pathologically proven combined HCC-CC (n = 20) and ICCs (n = 20) who had undergone gadoxetic acid-enhanced MRI were enrolled in this study. MR images were analyzed for the shape of lesions, hypo- or hyperintense areas on the T2-weighted image (T2WI), rim enhancement during early dynamic phases, and central enhancement with hypointense rim (target appearance) on the 10-min and 20-min hepatobiliary phase (HBP). The significance of these findings was determined by the χ(2) test.
Irregular shape and strong rim enhancement during early dynamic phases, and absence of target appearance on HBP favored combined HCC-CCs (P < 0.05). Lobulated shape, weak peripheral rim enhancement, and the presence of complete target appearance on the 10-min and 20-min HBP favored ICCs (P < 0.05). However, 10 CC-predominant type of combined HCC-CC showed complete or partial target appearance on 10-min HBP.
The shape of tumors, degree of rim enhancement during early dynamic phases, and target appearance on HBP were valuable for differentiating between combined HCC-CC and mass-forming ICC on gadoxetic acid-enhanced MRI.
探讨钆塞酸增强 MRI 鉴别富血供型肝内胆管细胞癌（ICC）与胆管细胞癌-肝细胞癌混合型（HCC-CC）的特征。
回顾性分析经病理证实的 40 例 HCC-CC（20 例）和 ICC（20 例）患者的临床及影像资料。分析病变的形态、T2WI 信号、早期动态增强扫描的边缘强化程度、10 分钟和 20 分钟肝胆期（HBP）是否存在“靶征”。采用 χ(2)检验分析各征象对两种肿瘤的鉴别诊断价值。
不规则形态、早期边缘强化显著、HBP 无“靶征”提示 HCC-CC（P<0.05）；分叶状形态、边缘强化轻、10 分钟和 20 分钟 HBP 均存在完整或部分“靶征”提示 ICC（P<0.05）。10 例 HCC 为主型 HCC-CC 中 10 分钟 HBP 可见完全或部分“靶征”。
肿瘤的形态、早期边缘强化程度、HBP 上的“靶征”对鉴别 HCC-CC 与富血供型 ICC 有一定价值。
