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MRI features identify combined hepatocellular-cholangiocarcinoma and intrahepatic cholangiocarcinoma with arterial rim enhancement
LI Zukun  ZHOU Changwu  QIAN Xianling  ZENG Mengsu  YANG Chun  LU Xin 

Cite this article as: Li ZK, Zhou CW, Qian XL, et al. MRI features identify combined hepatocellular-cholangiocarcinoma and intrahepatic cholangiocarcinoma with arterial rim enhancement[J]. Chin J Magn Reson Imaging, 2021, 12(11): 61-65. DOI:10.12015/issn.1674-8034.2021.11.013.


[Abstract] Objective To identify the MRI features of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and intrahepatic cholangiocarcinoma (ICC) with arterial rim enhancement, so as to provide some references for the preoperative differential diagnosis.Material and Methods: Seventy cHCC-CCA patients and 74 ICC patients confirmed by pathology were included in this study. Their contrast-enhanced MRI showed the arterial rim enhancement. The clinicopathological data and MRI characteristics of patients with cHCC-CCA and ICC were analyzed retrospectively. The differences of clinicopathological and MRI characteristics between cHCC-CCA and ICC patients were also compared.Results In this study, the incidence of intratumoral hemorrhage (25.7% vs. 9.5%, P=0.010), non-peripheral washout (51.4% vs. 9.5%, P＜0.001), enhancing capsule (60.0% vs. 14.9%, P＜0.001), nodule-in-nodule architecture (7.1% vs. 0%, P=0.025), and mosaic architecture (51.4% vs. 2.7%, P＜0.001) in cHCC-CCA with arterial rim enhancement were significantly higher than those of ICC. In contrast, the prevalence of target sign on DWI sequence (25.7% vs. 52.7%, P=0.001), delayed central enhancement (38.6% vs. 82.4%, P＜0.001) and hepatic capsule retraction (31.4% vs. 55.4%, P=0.004) in cHCC-CCA were significantly lower than those of ICC.Conclusions MRI features including non-peripheral washout, enhancing capsule, nodule-in-nodule architecture, and mosaic architecture, combined with elevated AFP, will be helpful to distinguish the cHCC-CCA with arterial rim enhancement from ICC.
[Keywords] combined hepatocellular-cholangiocarcinoma；intrahepatic cholangiocarcinoma；magnetic resonance imaging；rim enhancement；differential diagnosis

LI Zukun1   ZHOU Changwu2   QIAN Xianling2   ZENG Mengsu2   YANG Chun2   LU Xin2*  

1 Department of Medical Imaging Center, People's Hospital of Luoping County, Yunnan Province, Qujing 655800, China

2 Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China

Lu X, E-mail: luxcn@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS This article is supported by National Natural Science Foundation of China (No. 91859107).
Received  2021-06-22
Accepted  2021-08-27
DOI: 10.12015/issn.1674-8034.2021.11.013
Cite this article as: Li ZK, Zhou CW, Qian XL, et al. MRI features identify combined hepatocellular-cholangiocarcinoma and intrahepatic cholangiocarcinoma with arterial rim enhancement[J]. Chin J Magn Reson Imaging, 2021, 12(11): 61-65. DOI:10.12015/issn.1674-8034.2021.11.013.

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