Bile duct involvement in hepatocellular carcinoma: MR demonstration.
BACKGROUND
To determine the magnetic resonance (MR) features of hepatocellular carcinoma (HCC) with associated bile duct involvement.


METHODS
MR examinations of six patients (mean age, 62 years) demonstrating bile duct involvement due to HCC were retrospectively reviewed and compared to surgical and pathologic findings.


RESULTS
Three of the tumors were solitary, and three were multifocal. In two patients, MR showed direct biliary duct invasion by tumor. On T1-weighted MR images, four tumors were hypointense compared to the liver and two were isointense. On T2-weighted MR images, four tumors were hyperintense, and two were isointense. The two tumors studied with dynamic T1-weighted MR images obtained after intravenous administration of a gadolinium chelate, displayed enhancement similar to that of the liver. There was no evidence of a tumor capsule on either unenhanced or enhanced MR images. Intrahepatic bile duct dilatation was seen in five patients. The extrahepatic bile duct was normal in all cases.


CONCLUSIONS
Although rare, HCC should be included when considering the etiology of intrahepatic bile duct obstruction. Imaging features suggestive of the diagnosis by MR include intrabiliary tumor or bile duct obstruction with an associated hepatic mass.
Soyer
P
P
Department of Radiology, Johns Hopkins Hospital, Baltimore, MD 21287-2180, USA.
Laissy
J P
JP
Bluemke
D A
DA
Sibert
A
A
Menu
Y
Y
D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D001652:Bile Ducts / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis; D004108:Dilatation, Pathologic / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed