Image Findings of Sarcomatous Intrahepatic Cholangiocarcinoma Focused on Gd-EOB-DTPA Enhanced MRI: A Case Report

Sarcomatous Intrahepatic cholangiocarcinoma is a rare but an aggressive variant of cholangiocarcinoma with a very poor prognosis. A 79-year-old man was admitted to our hospital because of incidentally found liver mass. Magnetic resonance imaging (MRI) revealed well-defined hypointense mass on T1WI and heterogeneous hyperintense mass on T2WI. Gd-EOB-DTPA enhanced study shows peripheral rim-like enhancement in arterial phase and progressive concentric filling of contrast in delayed phase. And mass shows significant enhancement in hepatobiliary phase. The pathologic diagnosis was intrahepatic cholangiocarcinoma with sarcomatous change.

Usefulness of Gadobenate Dimeglumine - Enhanced Hepatobiliary Phase MR Imaging on Predicting Histological Grade of Hepatocellular Carcinoma

PURPOSE: To assess the usefulness of gadobenate dimeglumine-enhanced hepatobiliary phase MR imaging for evaluation of histological characteristics of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: 57 HCCs histopathologically proved by surgery in 51 patients were retrospectively evaluated. All patients underwent gadobenate dimeglumine-enhanced MR imaging prior to surgery. The signal-to-noise ratio (SNR) of lesion and liver, and the liver-to-lesion contrast-to-noise ratio (CNR) for both pre- and postcontrast hepatobiliary phase were measured and contrast enhancement ratio (CER) of lesion and liver were calculated to correlate with three groups stratified by histological grades (Edmondson-Steiner classification) of the lesions. The differences between means of each group were statistically analyzed with one-way analysis of variance test. RESULTS: The liver-to-lesion CNRs of well-differentiated HCCs (n=9) on pre- (-0.8+/-13.2) and postcontrast hepatobiliary phase images (13.2+/-30.4) were significantly lower (p<0.05) compared to those of moderately (14.2+/-9.4 and 39.1+/-15.4 on pre- and postcontrast, respectively) (n=37) and poorly differentiated HCCs (18.6+/-11.3 and 39.3+/-27.9) (n=11), respectively. There were no significant difference for CERs between three histological tumor grades. CONCLUSION: Gadobenate dimeglumine-enhanced hepatobiliary phase MR imaging can help predict the histological grades of hepatocellular carcinomas preoperatively, especially differentiating well- from moderately and poorly differentiated HCCs.