Cholangiocarcinoma echocardiography or ultrasound
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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 abdominal ultrasound, cholangiocarcinoma is characterized by obstruction and dilation of bile ducts. Mass-forming intrahepatic cholangiocarcinoma is characterized by hompgenous mass of intermediate echogenicity with a peripheral hypoechoic halo of compressed liver. Periductal infiltrating intrahepatic cholangiocarcinoma is characterized by capsular retraction. Intraductal cholangiocarcinoma is characterized by alterations in duct caliber, usually duct ectasia with or without a visible mass.
Abdominal imaging
Ultrasound of the liver and biliary tree is often used as the initial imaging modality in patients with suspected obstructive jaundice.[1][2] Ultrasound can identify obstruction and ductal dilatation and, in some cases, may be sufficient to diagnose cholangiocarcinoma.[3] On abdominal ultrasound, appearance of cholangiocarcinoma will vary according to the growth pattern.[4]
Mass-forming intrahepatic: tumors will be homogeneous mass of intermediate echogenicity with a peripheral hypoechoic halo of compressed liver. They tend to be well delineated but irregular in outline, and are often associated with capsular retraction, which if present is helpful in distinguishing cholangiocarcinomas from other hepatic tumors.
Periductal infiltrating intrahepatic: tumors typically are associated with altered caliber bile duct (narrowed or dilated) without a well-defined mass.
Intraductal: tumors are characterized by alterations in duct caliber, usually duct ectasia with or without a visible mass. If a polypoid mass is seen, it is usually hyperechoic compared to surrounding liver.
Contrast-enhanced ultrasound: may aid with diagnosis of cholangiocarcinoma:
- Arterial phase:
- Peripheral irregular rim-like enhancement
- Heterogeneous central hypoenhancement
- Portal venous phase / delayed phase:
- Decreased echogenicity relative to background liver ("wash out")
References
- ↑ Saini S (1997). "Imaging of the hepatobiliary tract". N Engl J Med. 336 (26): 1889–94. PMID 9197218.
- ↑ Sharma M, Ahuja V. "Aetiological spectrum of obstructive jaundice and diagnostic ability of ultrasonography: a clinician's perspective". Trop Gastroenterol. 20 (4): 167–9. PMID 10769604.
- ↑ Bloom C, Langer B, Wilson S. "Role of US in the detection, characterization, and staging of cholangiocarcinoma". Radiographics. 19 (5): 1199–218. PMID 10489176.
- ↑ Cholangiocarcinoma. Radiopaedia. http://radiopaedia.org/articles/cholangiocarcinoma