CT characteristics and differential diagnosis of mass-forming intrahepatic cholangiocarcinoma and liver abscess / 实用放射学杂志

ABSTRACT

Objective To analyze the CT characteristics and misdiagnosis reasons in mass-forming intrahepatic cholangiocarcinoma(ICC)and liver abscess to reduce the misdiagnosis rate.Methods CT features of 21 patients with mass-forming ICC and 20 patients with liver abscess proved by operation or puncture pathology were analyzed,in which 10 cases of mass-forming ICC were misdiagnosed as liver abscess.CT plain scan and three period enhanced scan were performed in 41 cases.Results Irregular edge enhancement rings,irregular patch or flocculent strengthened in delayed phase,arterial through surrounded lesions,liver capsule shrinkage,tissue nodule in intrahepatic bile duct,intrahepatic bile duct dilatation,hilar and retroperitoneal lymph node enlargement,portal vein invasion stenosis or occlusion,which possibility prompted to be the diagnosis of mass-forming ICC.Regular shape,slippery and intact ring-wall,edema syndrome around the ring wall,separate and annulate enhancement in delayed phase,reduction of tumor size and similar low density liquid in ring hints prompted to be the diagnosis of liver abscess.Liver abscess appears abnormal perfusion likely and significant.Conclusion Mass-forming ICC sharing similar imaging characteristics with liver abscess,having characteristic CT features.A comprehensive analysis of multiple signs may be helpful to arrive at a correct diagnosis.