CT and MRI findings of combined hepatocellular carcinoma and cholangiocarcinoma / 中华放射学杂志

ABSTRACT

Objective To investigate the imaging findings of combined hepatocellular carcinoma and cholangiocarcinoma(cHCC-CC) with dynamic MRI and spiral CT.Methods Twenty-three patients of cHCC-CC were evaluated.All patients had surgery and diagnoses were confirmed by histopathology.Eighteen patients had pre- and post-contrast scans with spiral CT.Five patients had MR with dynamic multi-phase contrast scanning.Imaging findings in all patients were retrospectively reviewed.Results CT of eighteen patients showed low-density masses with ill-defined margin (n =15 ),lymphadenopathy( n =5 ),invasion of blood vessels ( n =7 ),satellite lesions ( n =5 ),enhancing pseudocapsule ( n =9 ),and dilatation of intrahepatic ducts (n =1 ).MRI of five patients showed lesions with low signal on T1 WI and high signal on T2WI,lymphadenopathy(n =1 ),invasion of blood vessels (n =1 ),enhancing pseudocapsule (n =4).Dynamic CT or MRI enhanced scanning showed areas of heterogeneous enhancement in the interior or periphery of the tumor on the arterial phase,areas of inhomogeneous high signal ( corresponding regions of low signal on the arterial phase) on the portal venous phase,areas of mixed signal intensity due to retention of contrast agents on the delayed phase.Conclusions Combined hepatocellular carcinoma and cholangiocarcinom demonstrate imaging features on conventional and dynamic MRI and spiral CT,which can be helpful to improve the diagnostic accuracy of this disease.