Contribution of contrast-enhanced sonography in the detection of intrahepatic cholangiocarcinoma.
OBJECTIVE
The purpose of this study was to evaluate the contribution of contrast-enhanced sonography in the diagnosis of intrahepatic cholangiocarcinoma up to 3 cm and analyze its dynamic enhancement patterns.


METHODS
Forty-five patients (29 male and 16 female; mean age ± SD, 61.3 ± 10.7 years; range, 38-79 years) with a preliminary diagnosis of intrahepatic cholangiocarcinoma by contrast-enhanced sonography were retrospectively analyzed. For each nodule, the enhancement pattern, level, and dynamic change during the arterial, portal, and late phases after the injection of a sulfur hexafluoride microbubble contrast agent were evaluated.


RESULTS
Among the 35 patients with a histopathologic diagnosis of intrahepatic cholangiocarcinoma, 18 nodules showed hyperenhancement during the arterial phase, and 17 showed hypoenhancement. Heterogeneous, peripheral, and partial enhancement were found in 24, 8, and 2 nodules, respectively. However, only 1 nodule showed homogeneous enhancement. During the portal phase, 34 nodules showed hypoenhancement, and 1 showed isoenhancement. Hypoenhancement during the late phase was observed in all cases. Ten patients had a misdiagnosis of intrahepatic cholangiocarcinoma.


CONCLUSIONS
Intrahepatic cholangiocarcinoma up to 3 cm may display a variety of arterial enhancement patterns on contrast-enhanced sonography. However, some other nodules may manifest findings similar to those of intrahepatic cholangiocarcinoma.
Department of Ultrasound, Zhongshan Hospital, Fudan University, 180 Feng-lin Rd, 200032 Shanghai, China. puguang61@126.com.
Wen-Tao
WT
Kong
Wen-Ping
WP
Wang
Wei-Wei
WW
Zhang
Yu-Dong
YD
Qiu
Hong
H
Ding
Bei-Jian
BJ
Huang
D000328:Adult; D000368:Aged; D000465:Algorithms; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D014463:Ultrasonography / Q000379:methods*
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride
contrast-enhanced sonography; enhancement pattern; gastrointestinal ultrasound; intrahepatic cholangiocarcinoma; misdiagnosis