Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
Division of Hepatology, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Germany.
Dig Liver Dis. 2018 Apr;50(4):401-407. doi: 10.1016/j.dld.2017.11.003. Epub 2017 Nov 24.
Mixed hepatocellular cholangiocarcinoma is a rare form of primary liver cancer.
The aim of this study is to report the results of the use of contrast enhanced ultrasound in a series of patients with confirmed mixed hepatocellular cholangiocarcinoma and to provide an updated literature review.
Between January 2012 and October 2016, 25 Asian patients with confirmed mixed hepatocellular cholangiocarcinoma were included in this bicentric retrospective analysis. Clinical data as well recorded images of a standardized conventional B-mode ultrasound and contrast-enhanced ultrasound examination were interpreted by two blinded, independent, experienced radiologists in consensus.
All mixed hepatocellular cholangiocarcinoma lesions were heteroechoic on B-mode ultrasound, with ill-defined margins and irregular shapes. Arterial phase hyperenhancement was present in all 25 patients. Late-phase washout and hypoenhancement was present in 24/25 (96%) patients. However, rim-enhancement and early wash-out (which are common in cholangiocellular carcinoma) were found in over 60% of the cases.
Contrast-enhanced ultrasound demonstrated findings not typical for HCC in a large proportion of patients with confirmed mixed hepatocellular cholangiocarcinoma. Therefore, histological confirmation is crucial, especially in lesions with atypical findings.
混合性肝细胞胆管细胞癌是一种罕见的原发性肝癌。
本研究旨在报告一系列经证实的混合性肝细胞胆管细胞癌患者使用超声造影的结果，并提供最新的文献复习。
在 2012 年 1 月至 2016 年 10 月期间，这项回顾性、双中心研究纳入了 25 例经证实的混合性肝细胞胆管细胞癌亚洲患者。由两位经验丰富的、盲法的、独立的放射科医生对记录的常规 B 超和超声造影检查的图像和临床资料进行了分析。
所有混合性肝细胞胆管细胞癌病灶在 B 超上均呈不均匀回声，边界不清，形态不规则。25 例患者均在动脉期有增强表现。24/25（96%）例患者在延迟期有洗脱和低增强表现。然而，超过 60%的病例中存在边缘增强和早期洗脱（这些是胆管细胞癌的常见表现）。
在大多数经证实的混合性肝细胞胆管细胞癌患者中，超声造影显示出与 HCC 不典型的表现。因此，组织学证实是至关重要的，尤其是在有不典型表现的病灶中。
