Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Korea.
Department of Pathology, Yonsei University, College of Medicine, Seoul, Korea.
Eur Radiol. 2016 Feb;26(2):407-16. doi: 10.1007/s00330-015-3846-5. Epub 2015 May 23.
To assess whether gadoxetic acid-enhanced MRI could be used as a prognostic factor for intrahepatic mass-forming cholangiocarcinomas (IMCCs).
Forty-one patients with pathologically proven IMCCs who underwent preoperative gadoxetic acid-enhanced MRI were included. The signal intensity of the IMCCs on hepatobiliary phase (HBP) MRI was qualitatively analyzed by two radiologists, and categorized into intermediate or hypointense groups. Analysis of clinicopathological prognostic factors and correlations of imaging and histology were also performed. Survival time and time to recurrence (TTR) were analyzed.
Of the 41 IMCCs, 23 were in the intermediate group and 18 were in the hypointense group on HBP MRI. IMCCs in the intermediate group were associated with shorter survival time (P = 0.048) and TTR (P = 0.002) than the IMCCs of the hypointense group. Only the intermediate group on HBP MRI had a significantly shorter TTR on multivariate analysis (P = 0.012). The IMCCs of the intermediate group showed a tendency for more abundant tumour fibrous stroma than those of the hypointense group (P = 0.027).
The enhancement of IMCCs on HBP gadoxetic acid-enhanced MRI appears to correlate with tumour aggressiveness and outcomes due to the tumour fibrous stromal component. Thus, HBP images could be a useful prognostic factor for IMCCs after surgery.
• The enhancement of IMCCs on HBP correlates with the tumour fibrous stroma. • The enhancement of IMCCs on HBP MRI appears to correlate with prognosis. • Gadoxetic acid-enhanced MRI is helpful for predicting prognosis of IMCCs after surgery.
评估钆塞酸增强 MRI 是否可作为肝内肿块型胆管细胞癌（IMCC）的预后因素。
纳入 41 例经病理证实的 IMCC 患者，均行术前钆塞酸增强 MRI。两名放射科医生对 IMCC 肝胆期（HBP）MRI 的信号强度进行定性分析，并将其分为中等或低信号组。还对临床病理预后因素进行了分析，并对影像学和组织学进行了相关性分析。分析了生存时间和复发时间（TTR）。
在 41 个 IMCC 中，HBP MRI 上 23 个为中等信号组，18 个为低信号组。HBP MRI 中等信号组的 IMCC 生存时间（P=0.048）和 TTR（P=0.002）均短于低信号组。仅 HBP MRI 中等信号组在多变量分析中 TTR 明显缩短（P=0.012）。HBP MRI 中等信号组的 IMCC 肿瘤纤维基质成分较丰富，有缩短 TTR 的趋势（P=0.027）。
HBP 钆塞酸增强 MRI 上 IMCC 的增强程度似乎与肿瘤侵袭性和预后有关，这与肿瘤纤维基质成分有关。因此，HBP 图像可能是 IMCC 术后有用的预后因素。
HBP 上 IMCC 的增强与肿瘤纤维基质有关。
HBP MRI 上 IMCC 的增强似乎与预后有关。
钆塞酸增强 MRI 有助于预测 IMCC 术后的预后。
