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Objective To investigate the value of conventional magnetic resonance imaging(MRI) combined with magnetic resonance cholangiopancreatography(MRCP) for the diagnosis of portal cholangiocarcinoma (HCCA).Methods Fortysix patients with HCCA in Chaoyang Central Hospital from September 2014 to February 2016 were selected as the research subjects.The characteristics of conventional MRI and MRCP of HCCA were retrospectively analyzed.Results Among the 46 patients with HCCA,33 cases showed portal nodules or irregular lumps blurred with the adjacent tissues,13 cases showed no obvious lump.Among the 33 cases,there were 4 cases of left hepatic duct involvement,7 cases of right hepatic duct involvement,18 cases of the left and right hepatic duct confluence involvement and 4 cases of common hepatic duct involvement.The irregular lumps or portal nodules in coronal Fiesta showed equal signal and slightly higher signal in T2WI.The liver acquisition with volume acceleration (LAVA) scan of 33 cases of portal nodules or irregular lumps showed that 24 cases had no significant enhancement in arterial phase and significant enhancement in delayed phase;and 9 cases had slight enhancement in arterial phase and non significant intensification in delayed phase.The LAVA scan of the 13 cases without obvious lumps showed the thickening of the vascular wall in arterial phase,vascular stenosis,slight enhancement in arterial phase and the significant enhancement in delayed phase.The MRCP examination of 46 cases showed moderate or severe dilatation with "soft rattan like"changes in intrahepatic bile ducts.The rupture of the dilated bile duct in porta hepatis position was found in 33 cases of portal nodules or irregular lumps,and 13 cases showed " empty" or "rat tail-like" stenosis of hepatic portal.The accuracy rates of localization and qualitative diagnosis of conventional MRI in the 46 patients were 80.43％ (37/46) and 82.61％ (38/46),respectively;and those of conventional MRI combined with MRCP were 100.00％ (46/46) and 95.65％ (44/46),respectively.The accuracy rate of localization and qualitative diagnosis of HCCA by MRI combined with MRCP was significantly higher than that by conventional MRI(x2 =8.762,4.039;P ＜ 0.05).Conclusion MRI combined with MRCP has a high diagnostic value for HCCA.
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Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.
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Objective To explore the feasibility and clinical value of metallic stent in the management of unresectable hepatic portal cholangiocarcinoma. Methods A study was investigated in 17 patients with unresectable hepatic portal cholangiocarcinoma from January 1998 to January 2006. A memory alloy biliary stent was placed into the obstructive bile duct for internal biliary drainage. Results Patients’ jaundice disappeared within 2 weeks after the stent placement. Cholangiography via the drainage tube showed patent bile ducts. Follow-up surveys in 16 patients for 4~30 months (mean, 11.5 months) revealed a survival time of 4~20 months (mean, 11 months) in 13 fatal patients. The remaining 3 patients had survived 10, 12.5, and 30 months, respectively. Conclusions Placement of memory metallic biliary stent for patients with unresectable hepatic portal cholangiocarcinoma is an ideal palliative therapy, which is simple and effective for reducing jaundice.