Intrahepatic peripheral cholangiocarcinoma (IPCC): comparison between perfusion ultrasound and CT imaging.
OBJECTIVE
This study was done to compare the perfusion patterns of intrahepatic peripheral cholangiocarcinoma (IPCC) on contrast-enhanced ultrasound (CEUS) and dynamic computed tomography (CT).


METHODS
We retrospectively reviewed 23 histologically proven cases of IPCC. All lesions were studied by CEUS with sulfur hexafluoride-filled microbubbles coated with a phospholipid capsule, and by dynamic CT. Contrast-enhancement patterns were evaluated in the arterial phase (CEUS 10-20 s after the injection; CT 25-30 s after the injection) and in the delayed phase (CEUS 120 s after the injection; CT>2-3 min after the injection).


RESULTS
Lesions were single in 18/23 cases (78%), single with nearby satellite lesions in 1/23 (4%) cases and multifocal with distant secondary lesions in 4/23 (17%) cases. Lesion diameter was 2-5 cm in 7/23 cases (30%), 5-7 cm in 13/23 cases (57%) and >7 cm in 3/23 (13%) cases. On CEUS, lesions were hypervascular in 16/23 cases (70%). On delayed-phase CEUS, 22/23 lesions (96%) were markedly hypoechoic. CT showed that the lesions were hypovascular in the arterial phase in 15/23 cases (66%) and hypervascular in 7/23 (30%) cases; one lesion (1/23; 4%) was isovascular. On delayed-phase CT, lesions were hyperdense in 17/23 cases (74%), hypodense in 5/23 (22%) cases and isodense in 1/23 (43%) cases.


CONCLUSIONS
Enhancement discrepancy between delayed-phase CEUS (hypoechogenicity) and CT (hyperdensity) is common semiological findings in the study of IPCC.
D'Onofrio
M
M
Istituto di Radiologia, Università degli Studi di Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134 Verona, Italy. mirko.donofrio@univr.it
Vecchiato
F
F
Cantisani
V
V
Barbi
E
E
Passamonti
M
M
Ricci
P
P
Malagò
R
R
Faccioli
N
N
Zamboni
G
G
Pozzi Mucelli
R
R
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007472:Iohexol / Q000031:analogs & derivatives; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D010743:Phospholipids; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D007472:Iohexol; C038192:iopromide; D013459:Sulfur Hexafluoride