Vilgrain V, Van Beers B E, Flejou J F, Belghiti J, Delos M, Gautier A L, Zins M, Denys A, Menu Y
Department of Radiology, Hôpital Beaujon, Clichy, France.
J Comput Assist Tomogr. 1997 Jan-Feb;21(1):59-65. doi: 10.1097/00004728-199701000-00012.
Our goal was to determine the MR features of intrahepatic cholangiocarcinoma and to correlate them with pathologic findings in a surgical series.
MRI in 14 patients with intrahepatic cholangiocarcinoma who had undergone resection was reviewed. All patients had T1- and T2-weighted SE sequences. Contrast-material-enhanced MRI was performed in 12 cases. Comparison between findings at MRI and pathologic examination was made.
MRI depicted all the lesions but one satellite nodule of 2 cm diameter. All lesions were hypointense relative to the liver on T1-weighted images. On T2-weighted images, the tumors were predominantly isointense or slightly hyperintense relative to liver parenchyma in nine cases (64%) and were strongly hyperintense in five cases (36%). Central hypointense areas or bands were seen in eight cases. No capsule was detected. On contrast-enhanced MR studies, all lesions had progressive and concentric filling with contrast material. Associated findings such as vascular encasement, focal liver atrophy, or dilatation of intrahepatic bile ducts were observed in 10 cases (71%). Comparison with pathologic examination revealed that lesion signal intensity on T2-weighted MR images was due mostly to the amount of fibrosis, necrosis, and mucous secretion within the lesion. The nine isointense or slightly hyperintense lesions contained abundant fibrosis and had a low content of mucous secretion or necrosis, whereas the five hyperintense lesions contained low or moderate fibrosis and prominent mucous secretion and/or necrosis.
Our study suggests that the MR features of intrahepatic cholangiocarcinoma are well correlated with pathologic findings, but are nonspecific. Associated findings may strengthen the diagnosis of intrahepatic cholangiocarcinoma at MRI.
我们的目标是确定肝内胆管癌的磁共振成像（MR）特征，并将其与一组手术病例的病理结果相关联。
回顾性分析14例接受肝内胆管癌切除术患者的MRI资料。所有患者均行T1加权和T2加权自旋回波（SE）序列检查。12例患者行对比剂增强MRI检查。将MRI表现与病理检查结果进行对比。
MRI显示了所有病灶，但遗漏了一个直径2 cm的卫星结节。在T1加权图像上，所有病灶相对于肝脏呈低信号。在T2加权图像上，9例（64%）肿瘤相对于肝实质主要呈等信号或轻度高信号，5例（36%）呈明显高信号。8例可见中央低信号区或低信号带。未发现包膜。在对比增强MR研究中，所有病灶均有对比剂逐渐向心性填充。10例（71%）观察到相关表现如血管受侵、肝叶萎缩或肝内胆管扩张。与病理检查对比显示，T2加权MR图像上病灶信号强度主要取决于病灶内纤维化、坏死及黏液分泌量。9例等信号或轻度高信号病灶含有丰富的纤维化，黏液分泌或坏死含量低，而5例高信号病灶纤维化含量低或中等，黏液分泌和/或坏死明显。
我们的研究表明，肝内胆管癌的MR特征与病理结果具有良好的相关性，但缺乏特异性。相关表现可能有助于MRI诊断肝内胆管癌。
