Differentiation of Hepatocellular Carcinoma from Intrahepatic Cholangiocarcinoma as the Cause of Biliary Obstruction: Value of Dynamic CT During the Hepatic Arterial Phase
Journal of the Korean Radiological Society
;
: 659-666, 1998.
Article
in English
| WPRIM
| ID: wpr-211630
ABSTRACT
PURPOSE:
To evaluate the usefulness of dynamic CT during the hepatic arterial phase with rapid IV injection ofcontrast material in distinguishing hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma (ICAC) asthe cause of biliary obstruction. MATERIALS ANDMETHODS:
We retrospectively reviewed two-phase dynamic incrementalCT or helical CT findings in 22 patients with intrahepatic duct obstruction secondary to pathologically provenHCCs (n=12) or ICACs (n=10). Two-phase CT scans were obtained 20-45 seconds (hepatic arterial phase) or 2 minutes(equilibrium phase) after the initiation of a bolus injection of contrast material (5 mL/sec, 150 mL). Theenhancement patterns of tumors, as seen on two-phase images, were classified as hypo-, iso-, or hyperattenuated,relative to surrounding liver parenchyma. Two-phase images were compared and correlated with pathologic findings.RESULTS:
During the hepatic arterial phase, diffuse high-enhancement was seen in nine HCCs (75%) and partialenhancement in three (25%); five (50%) of the ten ICACs were hypodense and five (50%) were hypodense withperipheral enhancement. During the equilibrium phase, however, all HCCs were hypodense and capsular enhancementwas seen in four cases (33.3%). All ICACs were hypodense with mild peripheral or central heterogeneousenhancement. Contrast enhancement patterns of HCCs during the hepatic arterial phase were significantly different(P<.0001) from those of ICACs.CONCLUSION:
Our results suggest that dynamic CT during the hepatic arterial phase,with rapid IV injection of contrast material, is useful for the differentiation of HCC from ICAC as the cause ofbiliary obstruction.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Tomography, X-Ray Computed
/
Retrospective Studies
/
Cholangiocarcinoma
/
Carcinoma, Hepatocellular
/
Tomography, Spiral Computed
/
Liver
Type of study:
Observational study
Limits:
Humans
Language:
English
Journal:
Journal of the Korean Radiological Society
Year:
1998
Type:
Article
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