Cholangiocarcinoma CT: Difference between revisions

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{{Cholangiocarcinoma}}
{{Cholangiocarcinoma}}
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==Overview==
==Overview==
On [[Computed tomography|CT scan]], cholangiocarcinoma is characterized by homogeneously low in attenuation and demonstrate heterogeneous minor peripheral enhancement with gradual enhancement centrally. Capsular retraction may be observed.


==CT==
==CT scan==
[[Computed tomography]] (CT) scanning may also play an important role in the diagnosis of cholangiocarcinoma.<ref>{{cite journal |author=Valls C, Gumà A, Puig I, Sanchez A, Andía E, Serrano T, Figueras J |title=Intrahepatic peripheral cholangiocarcinoma: CT evaluation |journal=Abdom Imaging |volume=25 |issue=5 |pages=490-6 |year= |id=PMID 10931983}}</ref><ref>{{cite journal |author=Tillich M, Mischinger H, Preisegger K, Rabl H, Szolar D |title=Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma |journal=AJR Am J Roentgenol |volume=171 |issue=3 |pages=651-8 |year=1998 |id=PMID 9725291}}</ref><ref>{{cite journal |author=Zhang Y, Uchida M, Abe T, Nishimura H, Hayabuchi N, Nakashima Y |title=Intrahepatic peripheral cholangiocarcinoma: comparison of dynamic CT and dynamic MRI |journal=J Comput Assist Tomogr |volume=23 |issue=5 |pages=670-7 |year= |id=PMID 10524843}}</ref>
*Abdominal [[Computed tomography|CT scan]] may be helpful in the diagnosis of cholangiocarcinoma. Findings on [[Computed tomography|CT scan]] suggestive of cholangiocarcinoma include:<ref name="HanChoi2002">{{cite journal|last1=Han|first1=Joon Koo|last2=Choi|first2=Byung Ihn|last3=Kim|first3=Ah Young|last4=An|first4=Su Kyung|last5=Lee|first5=Joon Woo|last6=Kim|first6=Tae Kyung|last7=Kim|first7=Sun-Whe|title=Cholangiocarcinoma: Pictorial Essay of CT and Cholangiographic Findings|journal=RadioGraphics|volume=22|issue=1|year=2002|pages=173–187|issn=0271-5333|doi=10.1148/radiographics.22.1.g02ja15173}}</ref><ref name="pmid18773065">{{cite journal |vauthors=Vilgrain V |title=Staging cholangiocarcinoma by imaging studies |journal=HPB (Oxford) |volume=10 |issue=2 |pages=106–9 |year=2008 |pmid=18773065 |pmc=2504386 |doi=10.1080/13651820801992617 |url=}}</ref>
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**Capsular retraction 
Mass-forming cholangiocarcinomas: are typically homogeneously low in attenuation on noncontrast scans, and demonstrate heterogeneous minor peripheral enhancement with gradual enhancement centrally 2-3. The rate and extent of enhancement depends on the degree of central fibrosis 2.  Again, capsular retraction may be evident. The bile ducts distal to the mass are typically dilated.
**Dilation of [[Bile duct|bile ducts]] distal to the mass  
 
**Narrowing of the [[portal veins]] or [[hepatic veins]]
Although narrowing of the portal veins - or less frequently hepatic veins - is seen, unlike HCC, cholangiocarcinoma only rarely forms a tumor thrombus.
**Lobar or segmental hepatic atrophy associated with vascular invasion
 
[[image:CMRI2.PNG|500px|thumb|left|Ct scan showing Cholangiocarcinoma [https://radiopaedia.org/cases/cholangiocarcinoma-1 Source:Case Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 49009<ref name="urlCholangiocarcinoma | Radiology Case | Radiopaedia.org">{{cite web |url=https://radiopaedia.org/cases/cholangiocarcinoma-1 |title=Cholangiocarcinoma &#124; Radiology Case &#124; Radiopaedia.org |format= |work= |accessdate=}}</ref>]]]
Lobar or segmental hepatic atrophy is usually associated with vascular invasion.
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Periductal infiltrating: intra-hepatic tumours appear as regions of thickening of the periductal parenchyma with altered calibre of the involved duct (narrowed or dilated). These are most common at the hepatic hilum. There is usually some distal dilatation of the biliary tree.
 
Intraductal tumors: are characterised by alterations in duct calibre, usually ductectasia with or without a visible mass. If a polypoid mass is seen it is hypoattenuating on pre-contrast imaging, and demonstrates enhancement.
 
'''Delayed enhanced CT images demonstrate cholangiocarcinoma in the right hepatic lobe'''
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==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
[[Category:Disease]]
[[Category:Rare cancers]]
[[Category:Rare diseases]]
[[Category:Types of cancer]]
[[Category:Hepatology]]
[[Category:Gastroenterology]]


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Latest revision as of 19:03, 16 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

On CT scan, cholangiocarcinoma is characterized by homogeneously low in attenuation and demonstrate heterogeneous minor peripheral enhancement with gradual enhancement centrally. Capsular retraction may be observed.

CT scan

  • Abdominal CT scan may be helpful in the diagnosis of cholangiocarcinoma. Findings on CT scan suggestive of cholangiocarcinoma include:[1][2]
    • Capsular retraction
    • Dilation of bile ducts distal to the mass
    • Narrowing of the portal veins or hepatic veins
    • Lobar or segmental hepatic atrophy associated with vascular invasion
Ct scan showing Cholangiocarcinoma Source:Case Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 49009[3]


References

  1. Han, Joon Koo; Choi, Byung Ihn; Kim, Ah Young; An, Su Kyung; Lee, Joon Woo; Kim, Tae Kyung; Kim, Sun-Whe (2002). "Cholangiocarcinoma: Pictorial Essay of CT and Cholangiographic Findings". RadioGraphics. 22 (1): 173–187. doi:10.1148/radiographics.22.1.g02ja15173. ISSN 0271-5333.
  2. Vilgrain V (2008). "Staging cholangiocarcinoma by imaging studies". HPB (Oxford). 10 (2): 106–9. doi:10.1080/13651820801992617. PMC 2504386. PMID 18773065.
  3. "Cholangiocarcinoma | Radiology Case | Radiopaedia.org".

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