Hilar cholangiocarcinomas: T2-weighted spin-echo and gadolinium-enhanced FLASH MR imaging.
OBJECTIVE
To investigate the use of magnetic resonance (MR) imaging with dynamic gadopentetate dimeglumine enhancement in hilar cholangiocarcinoma.


METHODS
Twenty-four patients (14 men, 10 women; aged 27-78 years; mean age, 51 years) with hilar cholangiocarcinoma underwent T2-weighted spin-echo MR imaging in the axial plane and multisection, breath-hold, fast low-angle shot (FLASH) MR imaging in the coronal oblique plane before and at 30, 60, 90, and 120 seconds after bolus injection of gadopentetate dimeglumine. Morphologic features were recorded, and contrast medium enhancement characteristics and contrast-to-noise ratios were calculated for each sequence.


RESULTS
All the lesions were hyperintense on T2-weighted spin-echo images and hypointense on FLASH images. On dynamic gadolinium-enhanced images, progressive heterogeneous enhancement was seen in all patients. Intrahepatic ductal dilatation was present in every patient. Intraluminal components were seen in 11 patients, lobar atrophy in 12, and segmental portal venous occlusion or stenosis in 13. Satellite lesions were present in four patients, and hilar lymph nodal enlargement in 11. Contrast-to-noise ratios were statistically significantly higher on T2-weighted spin-echo images than on all other images.


CONCLUSIONS
Hilar cholangiocarcinomas have consistent enhancement and morphologic features that can be demonstrated with dynamic contrast-enhanced MR imaging.
MRI Unit, St James's University Hospital, Leeds, England.
J A
JA
Guthrie
J
J
Ward
P J
PJ
Robinson
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D018281:Cholangiocarcinoma / Q000175:diagnosis*; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006500:Hepatic Duct, Common; D006801:Humans; D018285:Klatskin Tumor / Q000175:diagnosis; D008099:Liver / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA