title: MRI of small intrahepatic mass-forming cholangiocarcinoma and atypical small hepatocellular carcinoma (≤3 cm) with cirrhosis and chronic viral hepatitis: a comparative study.
abstract: OBJECTIVE
  The objective was to identify the decision-making magnetic resonance (MR) features in differentiating small intrahepatic mass-forming cholangiocarcinoma (sIMCC) from atypical small hepatocellular carcinoma (sHCC) (≤3 cm) in patients with cirrhosis and chronic viral hepatitis.
  
  
  METHODS
  Signal features and relative contrast of sHCCs and sIMCCs in T2-weighted and dynamic enhanced imaging were analyzed. A subgroup comparison between the cirrhosis and noncirrhosis chronic viral hepatitis group was also made.
  
  
  RESULTS
  Univariate analysis revealed that tumor contours (P<.001), signals in T2-weighted (P<.001) and each phase of contrast-enhanced scanning (P<.001), enhancement patterns (P<.001), as well as accompanying findings of tumor capsule (P<.001), hepatic capsule retraction (P<.001), bile duct dilation (P=.031), and transient hepatic intensity difference (P=.002) were different between sIMCC and atypical sHCC. Multivariate analysis indicated that dynamic enhancement patterns (P<.001) and signals in T2-weighted images (P=.024) were independent predictors for differentiation. Confusing MR features were more often observed in the cirrhosis group compared with those in the noncirrhosis chronic viral hepatitis group.
  
  
  CONCLUSIONS
  Dynamic enhancement patterns and signals in T2-weighted images were the most important MR features to differentiate sIMCC from atypical sHCC with cirrhosis and chronic viral hepatitis.
authors.affiliation: Department of Radiology, Zhongshan Hospital, Shanghai Medical School, Fudan, University, Shanghai Medical Imaging Institute, No. 180 Fenglin Road, Xuhui, District, Shanghai 200032, China.
authors.forename: Ruo-Fan
authors.initials: RF
authors.lastname: Sheng
authors.affiliation: Department of Radiology, Zhongshan Hospital, Shanghai Medical School, Fudan, University, Shanghai Medical Imaging Institute, No. 180 Fenglin Road, Xuhui, District, Shanghai 200032, China. Electronic address: zengmengsu@gmail.com.
authors.forename: Meng-Su
authors.initials: MS
authors.lastname: Zeng
authors.affiliation: Department of Radiology, Zhongshan Hospital, Shanghai Medical School, Fudan, University, Shanghai Medical Imaging Institute, No. 180 Fenglin Road, Xuhui, District, Shanghai 200032, China.
authors.forename: Sheng-Xiang
authors.initials: SX
authors.lastname: Rao
authors.affiliation: Department of Pathology, Zhongshan Hospital, Shanghai Medical School, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ji
authors.affiliation: Department of Pathology, Zhongshan Hospital, Shanghai Medical School, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai 200032, China.
authors.forename: Ling-Li
authors.initials: LL
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D018281:Cholangiocarcinoma / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis*; D019698:Hepatitis C, Chronic / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged
chemical_list: D003287:Contrast Media
keywords: Cholangiocarcinoma; Hepatocellular carcinoma; Liver; Magnetic resonance imaging