Dynamic enhancing vascular pattern of intrahepatic peripheral cholangiocarcinoma on contrast-enhanced ultrasound: the influence of chronic hepatitis and cirrhosis.
OBJECTIVE
To analyse the dynamic enhancing features by real-time contrast-enhanced ultrasound (CEUS) of intrahepatic peripheral cholangiocarcinoma (ICC) in patients with chronic hepatitis and cirrhosis.


METHODS
CEUS was performed by using contrast pulse sequencing (CPS) imaging with mechanical index of <0.2 after injection of 2.4 mL of contrast agent. CEUS images of histologically confirmed ICC in 54 patents (15 patents with chronic hepatitis B, 16 patents with cirrhosis, and 23 patents with normal underlying liver) were analyzed.


RESULTS
Heterogeneous hyperenhancement was more frequently identified in ICC with chronic hepatitis (9 of 15, 60.0%, p = 0.000) and cirrhosis (8 of 16, 50.0%, p = 0.010) than in patients with normal liver (6 of 23, 26.1%) during arterial phase. The majority of ICC in patients with normal liver displayed peripheral hyperenhancement (13 of 23, 56.5%), than in patients with chronic hepatitis (4 of 15, 26.7%, p = 0.000) and cirrhosis (5 of 16, 31.3%, p = 0.001). Intense contrast uptake during the arterial phase (heterogeneous hyperenhancement or global hyperenhancement) followed by washout in venous phases was more frequently displayed in ICC patients with chronic hepatitis (11 of 15, 73.3%, p = 0.000) and in patients with cirrhosis (11 of 16, 68.8%, p = 0.000) than in ICC patients with normal underlying liver (8 of 23, 34.8%).


CONCLUSIONS
The enhancing vascular pattern of ICC on CEUS in patients with chronic hepatitis and cirrhosis is different from that in ICC without underlying liver disease. The enhancing vascular pattern is indistinguishable from HCC on CEUS in most ICC patients with chronic hepatitis or cirrhosis.
Department of Ultrasound, Southwest Hospital Affiliated to Third Military Medical University, Gaotangyan Street, Shapingba, Chongqing, 400038, People's Republic of China. Raylee_7991@yahoo.com.cn
Rui
R
Li
Xiaohang
X
Zhang
Kuan-Sheng
KS
Ma
Xiao-Wu
XW
Li
Feng
F
Xia
Hua
H
Zhong
Chun-Lin
CL
Tang
Yanli
Y
Guo
Xiao-Chu
XC
Yan
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000098:blood supply* / Q000150:complications* / Q000000981:diagnostic imaging*; D001653:Bile Ducts, Intrahepatic; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000098:blood supply* / Q000150:complications* / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride