Xing Li-Hong, Zhuo Li-Yong, Zhang Yu, Ma Xi, Ma Ze-Peng, Zhao Ying-Jia, Yin Xiao-Ping, Gao Bu-Lang
Department of CT/MRI Room, Affiliated Hospital of Hebei University, and Key Laboratory of Cancer Radiotherapy and Chemotherapy Mechanism and Regulations, Baoding, China.
Front Oncol. 2022 May 13;12:723089. doi: 10.3389/fonc.2022.723089. eCollection 2022.
To investigate the value of diffusion-weighted imaging (DWI) combined with the hepatobiliary phase (HBP) Gd-BOPTA enhancement in differentiating intrahepatic mass-forming cholangiocarcinoma (IMCC) from atypical liver abscess.
A retrospective analysis was performed on 43 patients with IMCCs (IMCC group) and 25 patients with atypical liver abscesses (liver abscess group). The DWI signal, the absolute value of the contrast noise ratio (│CNR│) at the HBP, and visibility were analyzed.
A relatively high DWI signal and a relatively high peripheral signal were presented in 29 patients (67.5%) in the IMCC group, and a relatively high DWI signal was displayed in 15 patients (60.0%) in the atypical abscess group with a relatively high peripheral signal in only one (6.7%) patient and a relatively high central signal in 14 (93.3%, 14/15). A significant (P<0.001) difference existed in the pattern of signal between the two groups of patients. On T2WI, IMCC was mainly manifested by homogeneous signal (53.5%), whereas atypical liver abscesses were mainly manifested by heterogeneous signal and relatively high central signal (32%, and 64%), with a significant difference (<0.001) in T2WI imaging presentation between the two groups. On the HBP imaging, there was a statistically significant difference in peripheral │CNR│ (< 0.001) and visibility between two groups. The sensitivity of the HBP imaging was significantly (=0.002) higher than that of DWI. The sensitivity and accuracy of DWI combined with enhanced HBP imaging were significantly (=0.002 and <0.001) higher than those of either HBP imaging or DWI alone.
Intrahepatic mass-forming cholangiocarcinoma and atypical liver abscesses exhibit different imaging signals, and combination of DWI and hepatobiliary-phase enhanced imaging has higher sensitivity and accuracy than either technique in differentiating intrahepatic mass-forming cholangiocarcinoma from atypical liver abscesses.
探讨扩散加权成像（DWI）联合肝胆期（HBP）钆贝葡胺增强成像在鉴别肝内肿块型胆管癌（IMCC）与非典型肝脓肿中的价值。
回顾性分析43例IMCC患者（IMCC组）和25例非典型肝脓肿患者（肝脓肿组）。分析DWI信号、HBP期对比噪声比绝对值（│CNR│）及可视化情况。
IMCC组29例患者（67.5%）表现为相对较高的DWI信号及相对较高的周边信号，非典型脓肿组15例患者（60.0%）表现为相对较高的DWI信号，其中仅1例患者（6.7%）表现为相对较高的周边信号，14例患者（93.3%，14/15）表现为相对较高的中心信号。两组患者信号模式存在显著差异（P<0.001）。在T2WI上，IMCC主要表现为均匀信号（53.5%），而非典型肝脓肿主要表现为不均匀信号及相对较高的中心信号（分别为32%和64%），两组T2WI成像表现存在显著差异（<0.001）。在HBP成像上，两组外周│CNR│（<0.001）及可视化情况存在统计学显著差异。HBP成像的敏感性显著高于DWI（=0.002）。DWI联合HBP增强成像的敏感性和准确性显著高于单独的HBP成像或DWI（分别为=0.002和<0.001）。
肝内肿块型胆管癌与非典型肝脓肿表现出不同的影像信号，DWI与肝胆期增强成像联合应用在鉴别肝内肿块型胆管癌与非典型肝脓肿方面比单独使用任何一种技术具有更高的敏感性和准确性。
