ลักษณะตรงแบบและนอกแบบทางเอกซเรย์คอมพิวเตอร์ของมะเร็งท่อน้ำดีชนิดก้อนในตับ

Abstract

Objective: To describe the dynamic contrast enhanced CT findings of typical and atypical intrahepatic mass-forming cholangiocarcinomas (IMCCs) and to compare imaging features of typical and atypical IMCCs. Materials and methods: A retrospective study reviewed of history and MDCT findings from January 2008 to June 2014 of 67 patients with pathologically proved intrahepatic mass-forming cholangiocarcinoma. The patients were divided into two groups; typical and atypical which depends on pattern of arterial enhancement and the data were analyzed for gender, age and abdominal MDCT findings of tumor appearance, tumor size, contrast enhancing pattern, percentage of progressive enhancement, intratumoral calcification, presence of hepatic capsular retraction, vascular encasement, tumor thrombus and bile duct dilatation. Results: All patients were classified into typical (27%) and atypical groups. The atypical group were subclassified into three groups; atypical group type 1 (no significant enhancement on HAP and later phases, 15%), atypical group type 2 (internal enhancement on HAP with progressive enhancement on later phases, 55%) and atypical group type 3 (internal enhancement on HAP with washout on later phases, 3%). Conclusion: Almost all of the IMCCs are hypoattenuation on plain scan. The typical pattern of enhancement (peripheral rim enhancement) is less common. The tumors in typical group are larger than the tumors in atypical groups. The most common enhancement pattern is atypical pattern type 2 (internal enhancement on HAP and progressive enhancement on later phases). This delayed enhancement pattern can be useful finding to make the diagnosis of IMCCs. Other common findings are bile duct dilatation and vascular encasement which are found in both typical and atypical groups. Keywords: Intrahepatic mass-forming cholangiocarcinomas, typical, atypical , imaging, CT