Differentiating combined hepatocellular and cholangiocarcinoma from mass-forming intrahepatic cholangiocarcinoma using gadoxetic acid-enhanced MRI

Jiyoung Hwang, Young Kon Kim, Min Jung Park, Mi Hee Lee, Seong Hyun Kim, Won Jae Lee, Hyun Chul Rhim

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69 Scopus citations

Abstract

Purpose: To examine the differential features of combined hepatocellular and cholangiocarcinoma (HCC-CC) from mass-forming intrahepatic cholangiocarcinoma (ICC) on gadoxetic acid-enhanced MRI. Materials and Methods: Forty patients with pathologically proven combined HCC-CC (n = 20) and ICCs (n = 20) who had undergone gadoxetic acid-enhanced MRI were enrolled in this study. MR images were analyzed for the shape of lesions, hypo- or hyperintense areas on the T2-weighted image (T2WI), rim enhancement during early dynamic phases, and central enhancement with hypointense rim (target appearance) on the 10-min and 20-min hepatobiliary phase (HBP). The significance of these findings was determined by the χ2 test. Results: Irregular shape and strong rim enhancement during early dynamic phases, and absence of target appearance on HBP favored combined HCC-CCs (P < 0.05). Lobulated shape, weak peripheral rim enhancement, and the presence of complete target appearance on the 10-min and 20-min HBP favored ICCs (P < 0.05). However, 10 CC-predominant type of combined HCC-CC showed complete or partial target appearance on 10-min HBP. Conclusion: The shape of tumors, degree of rim enhancement during early dynamic phases, and target appearance on HBP were valuable for differentiating between combined HCC-CC and mass-forming ICC on gadoxetic acid-enhanced MRI.

Original languageEnglish
Pages (from-to)881-889
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Volume36
Issue number4
DOIs
StatePublished - Oct 2012

Keywords

  • combined hepatocellular and cholangiocarcinoma
  • Gd-EOB-DTPA
  • intrahepatic cholangiocarcinoma
  • liver
  • MRI

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