Enhancement pattern of hilar cholangiocarcinoma: contrast-enhanced ultrasound versus contrast-enhanced computed tomography.
OBJECTIVE
To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT).


METHODS
Thirty-two consecutive patients with pathologically proven hilar cholangiocarcinomas were evaluated by both low mechanical index CEUS and CECT. The enhancement feature of the tumor, portal vein infiltration, and lesion conspicuity on them was investigated.


RESULTS
In the arterial phase, the numbers of the lesions showing hyperenhancement, isoenhancement, and hypoenhancement, were 14 (43.8%), 14 (43.8%), and 4 (12.6%), on CEUS, and 12 (37.5%), 9 (28.1%), and 11 (34.4%), on CECT (P=0.162). In portal phase, the numbers of the lesions showing hypoenhancement, isoenhancement, and hyperenhancement were 30 (93.8%), 1 (3.1%), and 1 (3.1%), on CEUS, and 23 (71.9%), 8 (25.0%), and 1 (3.1%), on CECT (P=0.046). The detection rates for portal vein infiltration were 84.2% (16/19) for baseline ultrasound, 89.5% (17/19) for CEUS, and 78.9% (15/19) for CECT (all P>0.05 between every two groups). CEUS significantly improved the lesion conspicuity in comparison with CECT. CEUS and CECT made correct diagnoses in 30 (93.8%) and 25 (78.1%) lesions prior to pathological examination (P=0.125).


CONCLUSIONS
The enhancement pattern of hilar cholangiocarcinoma on CEUS was similar with that on CECT in arterial phase, whereas in portal phase hilar cholangiocarcinoma shows hypoenhancement more likely on CEUS. CEUS and CECT lead to similar results in evaluating portal vein infiltration and diagnosis of this entity.
Xu
Hui-Xiong
HX
Department of Medical Ultrasonics, The First Affiliated Hospital, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou 510080, China. xuhuixiong@hotmail.com
Chen
Li-Da
LD
Xie
Xiao-Yan
XY
Xie
Xiao-Hua
XH
Xu
Zuo-Feng
ZF
Liu
Guang-Jian
GJ
Lin
Man-Xia
MX
Wang
Zhu
Z
Lu
Ming-De
MD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging; D006801:Humans; D007089:Image Enhancement; D007472:Iohexol / Q000031:analogs & derivatives; D018285:Klatskin Tumor / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D011169:Portal Vein / Q000000981:diagnostic imaging; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D055815:Young Adult
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D007472:Iohexol; C038192:iopromide; D013459:Sulfur Hexafluoride