Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008.
Department of Pathology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Jiangsu Province, China, 210008.
Eur Radiol. 2018 Jan;28(1):159-169. doi: 10.1007/s00330-017-4957-y. Epub 2017 Jul 27.
To explore the difference in contrast-enhanced computed tomography (CT) features of intrahepatic cholangiocarcinomas (ICCs) with different isocitrate dehydrogenase (IDH) mutation status.
Clinicopathological and contrast-enhanced CT features of 78 patients with 78 ICCs were retrospectively analysed and compared based on IDH mutation status.
There were 11 ICCs with IDH mutation (11/78, 14.1%) and 67 ICCs without IDH mutation (67/78, 85.9%). IDH-mutated ICCs showed intratumoral artery more often than IDH-wild ICCs (p = 0.023). Most ICCs with IDH mutation showed rim and internal enhancement (10/11, 90.9%), while ICCs without IDH mutation often appeared diffuse (26/67, 38.8%) or with no enhancement (4/67, 6.0%) in the arterial phase (p = 0.009). IDH-mutated ICCs showed significantly higher CT values, enhancement degrees and enhancement ratios in arterial and portal venous phases than IDH-wild ICCs (all p < 0.05). The CT value of tumours in the portal venous phase performed best in distinguishing ICCs with and without IDH mutation, with an area under the curve of 0.798 (p = 0.002).
ICCs with and without IDH mutation differed significantly in arterial enhancement mode, and the tumour enhancement degree on multiphase contrast-enhanced CT was helpful in predicting IDH mutation status.
• IDH mutation occurred frequently in ICCs. • ICCs with and without IDH mutation differed significantly in arterial enhancement mode. • ICCs with IDH mutation enhanced more than those without IDH mutation. • Enhancement ratio and tumour CT value can predict IDH mutation status.
探讨不同异柠檬酸脱氢酶（IDH）突变状态的肝内胆管细胞癌（ICC）的增强 CT 特征差异。
回顾性分析 78 例 ICC 患者的临床病理和增强 CT 特征，并根据 IDH 突变状态进行比较。
ICC 中 IDH 突变 11 例（11/78，14.1%），无 IDH 突变 67 例（67/78，85.9%）。IDH 突变型 ICC 比 IDH 野生型 ICC 更常出现肿瘤内动脉（p=0.023）。大多数 IDH 突变型 ICC 表现为边缘和内部增强（10/11，90.9%），而无 IDH 突变型 ICC 则在动脉期常表现为弥漫性（26/67，38.8%）或无增强（4/67，6.0%）（p=0.009）。IDH 突变型 ICC 在动脉期和门静脉期的 CT 值、增强程度和增强比值均显著高于 IDH 野生型 ICC（均 p<0.05）。门静脉期肿瘤 CT 值在鉴别 IDH 突变型和非突变型 ICC 方面表现最佳，曲线下面积为 0.798（p=0.002）。
有无 IDH 突变的 ICC 在动脉增强模式上有显著差异，多期增强 CT 上肿瘤的增强程度有助于预测 IDH 突变状态。
IDH 突变在 ICC 中频繁发生。
有无 IDH 突变的 ICC 在动脉增强模式上有显著差异。
IDH 突变型 ICC 的增强程度高于无 IDH 突变型 ICC。
增强比值和肿瘤 CT 值可预测 IDH 突变状态。
