Cholangiocarcinoma CT
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American Roentgen Ray Society Images of Cholangiocarcinoma CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
CT
Computed tomography (CT) scanning may also play an important role in the diagnosis of cholangiocarcinoma.[1][2][3]
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.
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 is usually associated with vascular invasion.
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
References
- ↑ Valls C, Gumà A, Puig I, Sanchez A, Andía E, Serrano T, Figueras J. "Intrahepatic peripheral cholangiocarcinoma: CT evaluation". Abdom Imaging. 25 (5): 490–6. PMID 10931983.
- ↑ Tillich M, Mischinger H, Preisegger K, Rabl H, Szolar D (1998). "Multiphasic helical CT in diagnosis and staging of hilar cholangiocarcinoma". AJR Am J Roentgenol. 171 (3): 651–8. PMID 9725291.
- ↑ Zhang Y, Uchida M, Abe T, Nishimura H, Hayabuchi N, Nakashima Y. "Intrahepatic peripheral cholangiocarcinoma: comparison of dynamic CT and dynamic MRI". J Comput Assist Tomogr. 23 (5): 670–7. PMID 10524843.