Department of Ultrasound, Zhongshan Hospital, Fudan University, 180 Feng-lin Rd, 200032 Shanghai, China.
J Ultrasound Med. 2014 Feb;33(2):215-20. doi: 10.7863/ultra.33.2.215.
The purpose of this study was to evaluate the contribution of contrast-enhanced sonography in the diagnosis of intrahepatic cholangiocarcinoma up to 3 cm and analyze its dynamic enhancement patterns.
Forty-five patients (29 male and 16 female; mean age ± SD, 61.3 ± 10.7 years; range, 38-79 years) with a preliminary diagnosis of intrahepatic cholangiocarcinoma by contrast-enhanced sonography were retrospectively analyzed. For each nodule, the enhancement pattern, level, and dynamic change during the arterial, portal, and late phases after the injection of a sulfur hexafluoride microbubble contrast agent were evaluated.
Among the 35 patients with a histopathologic diagnosis of intrahepatic cholangiocarcinoma, 18 nodules showed hyperenhancement during the arterial phase, and 17 showed hypoenhancement. Heterogeneous, peripheral, and partial enhancement were found in 24, 8, and 2 nodules, respectively. However, only 1 nodule showed homogeneous enhancement. During the portal phase, 34 nodules showed hypoenhancement, and 1 showed isoenhancement. Hypoenhancement during the late phase was observed in all cases. Ten patients had a misdiagnosis of intrahepatic cholangiocarcinoma.
Intrahepatic cholangiocarcinoma up to 3 cm may display a variety of arterial enhancement patterns on contrast-enhanced sonography. However, some other nodules may manifest findings similar to those of intrahepatic cholangiocarcinoma.
本研究旨在评估对比增强超声在诊断最大直径 3cm 以内肝内胆管细胞癌中的作用，并分析其动态增强模式。
回顾性分析了 45 例经对比增强超声初步诊断为肝内胆管细胞癌的患者（男 29 例，女 16 例；平均年龄±标准差，61.3±10.7 岁；范围，38-79 岁）。对于每个结节，评估了注射六氟化硫微泡造影剂后动脉期、门静脉期和晚期的增强模式、增强水平和动态变化。
在 35 例经组织病理学诊断为肝内胆管细胞癌的患者中，18 个结节在动脉期呈高增强，17 个呈低增强。24 个结节呈不均匀、周边和部分增强，8 个结节呈均匀增强，2 个结节呈均匀增强。然而，只有 1 个结节呈均匀增强。在门静脉期，34 个结节呈低增强，1 个结节呈等增强。所有病例在晚期均呈低增强。10 例患者误诊为肝内胆管细胞癌。
最大直径 3cm 以内的肝内胆管细胞癌在对比增强超声上可能表现出多种动脉增强模式，但有些其他结节可能表现出与肝内胆管细胞癌相似的表现。
