Department of Radiology, State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, PR China; Cancer Prevention Center, State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, PR China.
Department of Radiology, State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, PR China.
Clin Radiol. 2019 May;74(5):407.e1-407.e10. doi: 10.1016/j.crad.2019.01.016. Epub 2019 Feb 21.
To determine the enhanced computed tomography (CT) and magnetic resonance imaging (MRI) characteristics of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) in Chinese patients.
Patients with histopathologically proven cHCC-CC (n=54) were compared with hepatocellular carcinoma (HCC; n=41) and cholangiocellular carcinoma (CCC; n=41) patients. Clinical information was measured in all patients. Tumour size, tumour margins, signs of cirrhosis, pseudocapsule, capsular retraction, rim enhancement, intrahepatic biliary dilatation, portal vein thrombosis, upper abdominal lymphadenopathy, were assessed on CT and/or MRI. The dynamic pattern of enhancement was also assessed.
The majority (81.5%) of cHCC-CC patients had positive hepatitis B serology. The presence of cirrhosis and tumour blood vessels was comparable in cHCC-CC and HCC, but significantly lower in CCC (p>0.05). The presence of ill-defined margin and regional lymphadenopathy was comparable in cHCC-CC and CCC, but significantly lower in HCC (p>0.05). The pseudocapsule, capsular retraction, biliary dilatation, rim enhancement, and abnormal perfusion were significantly different between the three types of lesions, with cHCC-CC being intermediate between HCC and CCC. Nearly half of the cHCC-CC tumours (25; 46.3%) showed the wash-in and wash-out enhancement pattern; the gradual, persistent, and mixed patterns were seen in 12 (22.2%), 5 (9.3%), and 12 (22.2%) tumours, respectively.
The majority of cHCC-CC tumours occur against a background of positive hepatitis B serology and cirrhosis. Imaging findings vary widely between cHCC-CC tumours. In the present series, the enhancement pattern of cHCC-CC tumours was HCC-like in most cases.
确定中国患者的肝细胞癌-胆管细胞癌（cHCC-CC）的增强计算机断层扫描（CT）和磁共振成像（MRI）特征。
将经组织病理学证实的 cHCC-CC 患者（n=54）与肝细胞癌（HCC；n=41）和胆管细胞癌（CCC；n=41）患者进行比较。对所有患者进行临床资料测量。在 CT 和/或 MRI 上评估肿瘤大小、肿瘤边缘、肝硬化征象、假包膜、包膜回缩、边缘强化、肝内胆管扩张、门静脉血栓形成、上腹部淋巴结肿大。还评估了增强的动态模式。
大多数（81.5%）cHCC-CC 患者的乙型肝炎血清学呈阳性。cHCC-CC 和 HCC 患者的肝硬化和肿瘤血管存在相似，但 CCC 患者的存在明显较低（p>0.05）。cHCC-CC 和 CCC 患者的边界不清晰和区域淋巴结肿大存在相似，但 HCC 患者的存在明显较低（p>0.05）。假包膜、包膜回缩、胆管扩张、边缘强化和异常灌注在三种病变类型之间存在显著差异，cHCC-CC 介于 HCC 和 CCC 之间。近一半的 cHCC-CC 肿瘤（25；46.3%）显示出“快进快出”强化模式；12 例（22.2%）、5 例（9.3%）和 12 例（22.2%）肿瘤分别表现为逐渐、持续和混合模式。
大多数 cHCC-CC 肿瘤发生在乙型肝炎血清学和肝硬化的背景下。cHCC-CC 肿瘤的影像学表现差异很大。在本系列中，大多数 cHCC-CC 肿瘤的强化模式呈 HCC 样。
