Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, 920-8640, Japan.
Department of Radiological Technology, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Jpn J Radiol. 2019 Oct;37(10):669-684. doi: 10.1007/s11604-019-00860-0. Epub 2019 Aug 1.
Cholangiocarcinoma (CC) is a malignant tumor which arises from the biliary epithelium and most cases represent adenocarcinoma. CC can be classified into intrahepatic CC (ICC), perihilar CC, and distal CC, based on the site of anatomic origin. The incidence of ICC is increasing in both Western and Eastern countries, while that of extrahepatic cholangiocarcinoma remains fairly stable. ICC infiltrates into adjacent nerves and lymphatic vessels, resulting in progressive disease with a poor prognosis; thus, early detection of ICC is critical for achieving better outcomes and providing better patient care. However, it is difficult for clinicians to detect an ICC, especially in its early stage. Different from hepatocellular carcinoma, the lack of surveillance system for the high-risk group of CC does not allow for a reliable screening examination. In this context, for early detection and diagnosis of ICC, radiologists need to know predisposing conditions that can lead to the development of ICC, such as chronic biliary or hepatic inflammation, primary sclerosing cholangitis, congenital biliary diseases, and other conditions. In this article, we discuss and illustrate the radiologic features of ICC with special attention to early disease stages and of predisposing conditions of ICC.
胆管癌（CC）是一种起源于胆管上皮的恶性肿瘤，大多数情况下为腺癌。根据解剖起源部位，CC 可分为肝内 CC（ICC）、肝门部 CC 和远端 CC。ICC 在西方国家和东方国家的发病率都在增加，而肝外胆管癌的发病率则相对稳定。ICC 浸润邻近的神经和淋巴管，导致疾病进展，预后不良；因此，早期发现 ICC 对于获得更好的结果和提供更好的患者护理至关重要。然而，临床医生很难发现 ICC，尤其是在早期阶段。与肝细胞癌不同，CC 的高危人群缺乏监测系统，无法进行可靠的筛查检查。在这种情况下，为了早期发现和诊断 ICC，放射科医生需要了解可能导致 ICC 发展的易患情况，如慢性胆道或肝脏炎症、原发性硬化性胆管炎、先天性胆道疾病和其他情况。本文讨论并说明了 ICC 的放射学特征，特别关注早期疾病阶段和 ICC 的易患情况。
