Department of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
Sci Rep. 2019 Dec 18;9(1):19363. doi: 10.1038/s41598-019-55857-6.
The objective of this study was to illustrate our specific findings for intrahepatic cholangiocarcinoma (ICC) lesions on contrast-enhanced ultrasound (CEUS). In this study, 21 patients at our hospitals with pathologically proven ICC and CEUS data were retrospectively enrolled. General clinical data of the patients, and features of lesions on conventional and contrast-enhanced ultrasound were recorded. Two experienced radiologists retrospectively reviewed all images by consensus. On gray-scale sonography, hypoechoic, isoechoic and hyperechoic lesions accounted for 85.7%, 9.5% and 4.8%, respectively, of all lesions. Hypovascular patterns were found for 95.2% of the lesions on color Doppler flow imaging. During the arterial phase of CEUS, heterogeneous hyperenhancement, homogeneous hyperenhancement, rim-like hyperenhancement, isoenhancement and hypoenhancement were observed for 61.9%, 19.0%, 9.5%, 4.8%, 4.8% of the lesions, respectively. During the portal venous and late phases, 85.7% and 95.2% of the lesions, respectively, exhibited hypoenhancement. In addition, 66.7% of the ICC lesions exhibited washed-out interiors but little decrease in enhancement at the periphery during the portal venous phase, resulting in the formation of a hyperenhanced peripheral rim. In conclusion, the rim sign in the portal venous phase of CEUS could help diagnose ICC. This trait could be related to the infiltrating growth pattern of ICC.
本研究旨在展示我们在对比增强超声（CEUS）中对肝内胆管癌（ICC）病变的具体发现。本研究回顾性纳入了我院 21 例经病理证实为 ICC 且具有 CEUS 数据的患者。记录了患者的一般临床资料和常规及对比增强超声上的病灶特征。两位有经验的放射科医生通过共识对所有图像进行了回顾性分析。在灰阶超声上，所有病灶中低回声、等回声和高回声分别占 85.7%、9.5%和 4.8%。彩色多普勒血流成像上 95.2%的病灶表现为低血流模式。在 CEUS 的动脉期，分别有 61.9%、19.0%、9.5%、4.8%和 4.8%的病灶表现为不均匀高增强、均匀高增强、边缘样高增强、等增强和低增强。在门静脉期和延迟期，分别有 85.7%和 95.2%的病灶表现为低增强。此外，66.7%的 ICC 病灶在门静脉期表现为内部洗脱，但周边增强程度下降较小，形成高增强的边缘环。总之，CEUS 门静脉期的边缘环征象有助于 ICC 的诊断。这种特征可能与 ICC 的浸润性生长模式有关。
