title: Intrahepatic and hilar mass-forming cholangiocarcinoma: Qualitative and quantitative evaluation with diffusion-weighted MR imaging.
abstract: OBJECTIVE
  To qualitatively and quantitatively analyze the presentation of intrahepatic and hilar mass-forming cholangiocarcinoma with diffusion-weighted magnetic resonance imaging (DW-MRI).
  
  
  METHODS
  Twenty-eight patients with histopathologically proven mass-forming cholangiocarcinoma (hilar, n=17; intrahepatic, n=11) underwent hepatic DW-MRI at 1.5-T using free-breathing acquisition and three b-values (0,400,800s/mm(2)). Cholangiocarcinomas were evaluated qualitatively using visual analysis of DW-MR images and quantitatively with conventional ADC and normalized ADC measurements using liver and spleen as reference organs.
  
  
  RESULTS
  All cholangiocarcinomas (28/28; 100%) were visible on DW-MR images. DW-MRI yielded best conspicuity of cholangiocarcinomas than the other MRI sequences (P<0.001). Seven cholangiocarcinomas (7/11; 64%) showed hypointense central area on DW-MR images. Conventional ADC value of cholangiocarcinomas (1.042×10(-3)mm(2)/s±0.221×10(-3)mm(2)/s; range: 0.616×10(-3)mm(2)/s to 2.050×10(-3)mm(2)/s) was significantly lower than that of apparently normal hepatic parenchyma (1.362×10(-3)mm(2)/s±0.187×10(-3)mm(2)/s) (P<0.0001), although substantial overlap was found. No significant differences in ADC and normalized ADC values were found between intrahepatic and hilar cholangiocarcinomas. The use of normalized ADC using the liver as reference organ resulted in the most restricted distribution of ADC values of cholangiocarcinomas (variation coefficient=16.6%).
  
  
  CONCLUSIONS
  There is a trend towards a common appearance of intrahepatic and hilar mass-forming cholangiocarcinomas on DW-MRI but variations may be observed. Familiarity with these variations may improve the diagnosis of mass-forming cholangiocarcinoma.
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France. Electronic address: hassangreenmed@gmail.com.
authors.forename: Hassan El
authors.initials: HE
authors.lastname: Fattach
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010 Paris, France; UMR INSERM 965-Paris 7 "Angiogenèse et recherche translationnelle", 2 rue Amboise Paré, 75010 Paris, France. Electronic address: anthony.dohan@lrb.aphp.fr.
authors.forename: Anthony
authors.initials: A
authors.lastname: Dohan
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France. Electronic address: docyoucef05@yahoo.fr.
authors.forename: Youcef
authors.initials: Y
authors.lastname: Guerrache
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010 Paris, France. Electronic address: raphael.dautry@lrb.aphp.fr.
authors.forename: Raphael
authors.initials: R
authors.lastname: Dautry
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France. Electronic address: mourad.boudiaf@lrb.aphp.fr.
authors.forename: Mourad
authors.initials: M
authors.lastname: Boudiaf
authors.affiliation: Department of Radiology, Hôpital Robert Debré, 11 Boulevard Pasteur, 51092 Reims Cedex, France. Electronic address: choeffel-fornes@chu-reims.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Hoeffel
authors.affiliation: Department of Abdominal Imaging, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, 10 Avenue de Verdun, 75010 Paris, France; UMR INSERM 965-Paris 7 "Angiogenèse et recherche translationnelle", 2 rue Amboise Paré, 75010 Paris, France. Electronic address: philippe.soyer@lrb.aphp.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Soyer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D018281:Cholangiocarcinoma / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D018285:Klatskin Tumor / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Diffusion-weighted magnetic resonance imaging; Hilar cholangiocarcinoma; Intrahepatic cholangiocarcinoma; MR Imaging; Malignant hepatic tumor; Normalized ADC