Cholangiocarcinoma CT

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

Overview

On CT scan, cholangiocarcinoma is characterized by homogenously low in attenuation and demonstrate heterogenous minor peripheral enhancement with gradual enhancement centrally. Capsular retraction may be observed. Bile ducts distal to the mass are typically dilated.

CT

Computed tomography (CT) scan 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 CT scan and demonstrate heterogeneous minor peripheral enhancement with gradual enhancement centrally.[4]
  • The rate and extent of enhancement depends on the degree of central fibrosis.
  • Capsular retraction may be observed.
  • Bile ducts distal to the mass are typically dilated.
  • Narrowing of the portal veins or hepatic veins is observed.
  • Lobar or segmental hepatic atrophy is usually associated with vascular invasion.

Periductal infiltrating intra-hepatic tumors appear as regions of thickening of the periductal parenchyma with altered caliber 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 cholangiocarcinomas are characterized by alterations in duct caliber, usually ductectasia with or without a visible mass. If a polypoid mass is observed, it is hypoattenuating on pre-contrast imaging, and demonstrates enhancement.

Delayed enhanced CT images demonstrate cholangiocarcinoma in the right hepatic lobe

References

  1. 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.
  2. 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.
  3. 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.
  4. Cholangiocarcinoma. Radiopaedia. http://radiopaedia.org/articles/cholangiocarcinoma

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