Enhancement pattern of hilar cholangiocarcinoma: comparison between contrast-enhanced sonography and contrast-enhanced computed tomography / 中华超声影像学杂志

ABSTRACT

Objective To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced sonography(CEUS) and contrast-enhanced computed tomography(CECT). Methods Thirty-two hilar cholangiocarcinoma lesions in 32 patients were evaluated by CEUS and CECT. CEUS was performed with contrast agent of SonoVue and low mechanical index contrast specific mode. CECT was performed with contrast media of Ultravist and a standard biphasic helical CT scanning protocol. Results In arterial phase of CEUS and CECT,the numbers of the lesions showing hyper-enhancement were 14 (43.8 % ) and 12 (37.5 % ), iso-enhancement were 14 (43.8%) and 9(28. 1%),hypo-enhancement were 4(12.5%) and 11(34.4%),respectively (P = 0. 162).Three lesions (9.4%) showed periphery rim-like hyper-enhancement and 29 (90.6%) showed diffuse homogeneous or heterogeneous enhanced of the whole tumor on CEUS, whereas for CECT the number were 2 (6. 3%) and 30 (93. 8%) respectively ( P = 1. 000). In portal phase, the numbers of the lesions showing hypo-enhancement on CEUS and CECT were 30 (93.8 % ) and 23 ( 71.90% ), iso-enhancement were 1 ( 3.1 % ) and 8 ( 25.0 % ), hyper-enhancement were 1(3. 1%) and 1 (3. 1%), respectively ( P = 0. 046). The portal vein invasion was correctly detected in 16 ( 84. 2 % ), 17 (89. 5 % ), 15 (78.9 % ) lesions with baseline ultrasound, CEUS and CECT, respectively. CEUS and CECT correctly diagnosed 30(93.8% ) and 25 (78. 1% ) lesions prior to operation (P = 0. 125). Conclusions The enhancement pattern of hilar cholangiocarcinoma on CEUS was similar with that on CECT in arterial phase, whereas in portal phase hilar cholangiocarcinoma was prone to show hypo-enhancement on CEUS. CEUS and CECT has similar diagnostie efficacy prior to operation.