XIAO Yangrui,MAO Weibo,LI Bingrong, et al. The MRI features and pathology of intrahepatic mass-forming cholangiocarcinoma with rich arterial blood supply[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2020, 50(10): 800-804.
Abstract：Objective: To investigate the MRI features and pathology of intrahepatic mass-forming cholangiocarcinoma (IMCC) with rich arterial blood supply. Methods: A retrospective analysis was made of the initial-diagnosis MR data of IMCC patients pathologically confirmed in Lishui Central Hospital from November 2008 to July 2019. Totally 14 lesions (in 14 IMCC patients) showing extensive enhancement of arterial phase were included in the study, and their imaging characteristics, including the general condition of the lesion, the signal on plain scan and DWI, the enhancement pattern and accompanying signs of surrounding tissues were analyzed. Results: The MICC with rich arterial blood supply mostly demonstrated as nodule or small mass, with regular morphology and clear boundary; the T1WI was relatively uniform low signal; while the T2WI and DWI were uniform or uneven high signal. There were three enhancement patterns: Type I, 9 cases (9/14), demonstrated whole or nearly whole enhancement in the arterial phase and continuously stable enhancement in the later period;Type II, 4 cases (4/14), demonstrated thick ring-enhancement in the arterial phase and continuously stable enhancement in the later period; Type III, 1 case (1/14), demonstrated overall enhancement in the arterial phase and quick washout in the portal venous phase. Otherwise, 7 cases (7/14) had liver fibrosis background; 6 cases(6/14) showed transient abnormal perfusion enhancement around the neoplasm in the arterial phase; 6 cases (6/14)showed pseudocapsule with delayed enhancement. Overall, no cases showed obvious steatosis, hemorrhage,bile duct dilatation or hepatic envelope depression. Dense distribution of tumor cells, abundant vascular fissures,yet loose distribution of fibrous stroma, rare coagulation necrosis and hemorrhage were the pathological fea-tures of IMCC with rich arterial blood supply. Conclusion: IMCC with rich arterial blood supply demonstrated specific MRI features of its own, which is of clinical value.
