Nam Ju Gang, Lee Jeong Min, Joo Ijin, Ahn Su Joa, Park Jin Young, Lee Kyoung Bun, Han Joon Koo
Department of Radiology, Dongnam Institution of Radiological and Medical Sciences, Busan, South Korea.
J Comput Assist Tomogr. 2018 May/Jun;42(3):340-349. doi: 10.1097/RCT.0000000000000695.
The aim of this study was to determine the value of multi-detector row computed tomography (MDCT) in differentiating the small-duct (SD) and large-duct (LD) types of intrahepatic mass-forming cholangiocarcinomas (IMCCs) and predicting patient prognosis.
The 4-phase MDCT image findings of 82 patients with surgically confirmed IMCCs (60 SD-type and 22 LD-type IMCCs) were compared between 2 types using univariate and multivariate analyses. Overall survival rates for 78 patients with available information were compared using the Kaplan-Meier method.
Arterial hyperenhancement, round or lobulated contour, and lack of bile duct encasement were significant MDCT features suggesting the SD type, and lymph node enlargement was significantly associated with the LD type (all P's < 0.05). The presence of those 3 SD-type-suggestive features (MDCT-suggested SD type) demonstrated high specificity (90.9% [20/22]) in differentiating the SD type. Patients of MDCT-suggested SD type without lymph node enlargement (n = 24) demonstrated significantly better overall survival than other groups.
Preoperative MDCT features of IMCCs can help differentiate the SD and LD types and predict patient prognosis.
本研究旨在确定多排螺旋计算机断层扫描（MDCT）在鉴别肝内肿块型胆管癌（IMCC）的小导管（SD）型和大导管（LD）型以及预测患者预后方面的价值。
采用单因素和多因素分析比较82例经手术证实的IMCC患者（60例SD型和22例LD型IMCC）的4期MDCT图像表现。采用Kaplan-Meier法比较78例有可用信息患者的总生存率。
动脉期强化、圆形或分叶状轮廓以及无胆管包绕是提示SD型的重要MDCT特征，而淋巴结肿大与LD型显著相关（所有P值<0.05）。这3个提示SD型的特征（MDCT提示的SD型）在鉴别SD型时具有较高特异性（90.9%[20/22]）。MDCT提示为SD型且无淋巴结肿大的患者（n = 24）的总生存率明显高于其他组。
IMCC的术前MDCT特征有助于鉴别SD型和LD型，并预测患者预后。
