title: Cholangiocarcinoma: spectrum of appearances on Gd-EOB-DTPA-enhanced MR imaging and the effect of biliary function on signal intensity.
abstract: BACKGROUND
  To describe the Gd-EOB-DTPA-enhanced MRI appearances of cholangiocarcinoma, and evaluate the relative signal intensities (RSIs) changes of major abdominal organs, and investigate the effect of total bilirubin (TB) levels on the RSI.
  
  
  METHODS
  25 patients with pathologically-proven cholangiocarcinoma underwent Gd-EOB-DTPA-enhanced MRI. The visualization of the biliary system during biliary phase (BP) was observed. RSIs of the abdominal aorta (A), portal vein (V), liver (L), and spleen (S) were measured.
  
  
  RESULTS
  On hepatocellular phase (HP), exophytic tumors (n =10) and infiltrative tumors (n =10) were hypointense, polypoid tumors (n = 2) were hypointense, and combined type tumors (n = 3) had mixed appearances. While patients with normal TB levels (≤22 μmol/L, n = 12) had clear visualization of the biliary tree during BP, those with elevated TB levels (>22 μmol/L, n = 13) had obscured or no visualization. In addition, patients with normal TB levels had higher RSIA, RSIV and RSIS than those with elevated TB levels on all dynamic phases (P <0.001), and lower RSIA, RSIV and RSIS on HP and BP (P <0.001). Patients with normal TB levels had higher RSIL than those with elevated TB levels on all phases (P <0.001).
  
  
  CONCLUSIONS
  RSIs of major abdominal organs reflected underlying biliary function. Cholangiocarcinoma patients with elevated TB levels had delayed excretion of Gd-EOB-DTPA compared with patients with normal TB levels.
authors: Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, 510080, China. fst1977@163.com.
authors: Shi-Ting
authors: ST
authors: Feng
authors: Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, 510080, China. wuling254.student@sina.com.
authors: Ling
authors: L
authors: Wu
authors: Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, 510080, China. huimiezhiyan@163.com.
authors: Huasong
authors: H
authors: Cai
authors: Medical Imaging Department, Union Hospital, Hong Kong, 18 Fu Kin Street, Tai Wai, Shatin, NT, Hong Kong. taochan@hku.hk.
authors: Tao
authors: T
authors: Chan
authors: Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, 510080, China. 583149136@qq.com.
authors: Yanji
authors: Y
authors: Luo
authors: Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, 510080, China. asrachel@126.com.
authors: Zhi
authors: Z
authors: Dong
authors: Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, 510080, China. zheng-keguo@163.com.
authors: Keguo
authors: K
authors: Zheng
authors: Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58th, The Second Zhongshan Road, Guangzhou, Guangdong, 510080, China. liziping163@163.com.
authors: Zi-Ping
authors: ZP
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis*; D001663:Bilirubin / Q000097:blood; D018281:Cholangiocarcinoma / Q000150:complications / Q000175:diagnosis*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D047368:Tumor Burden; D055815:Young Adult
chemical_list: C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA; D001663:Bilirubin
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