MR enhancement features of small combined hepatocellular-cholangiocarcinoma and its pathological basis#br#
XU Xiaofei1, LI Bingrong1, MAO Weibo2, XIAO Yangrui1, WANG Zufei1.
Department of Radiology, Lishui Central Hospital, Zhejiang Key Laboratory of Imaging Diagnosis and Intervention Minimally Invasive, Lishui 323000, China; 2.Department of Pathology, Lishui Central Hospital, Lishui 323000, China
XU Xiaofei,LI Bingrong,MAO Weibo, et al. MR enhancement features of small combined hepatocellular-cholangiocarcinoma and its pathological basis#br#[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2021, 51(1): 53-57.
Abstract：Objective: To investigate the MR enhancement features of small combined hepatocellular-cholangiocarcinoma (sCHC) and its pathological basis. Methods: The clinical and imaging data of 24 patients pathologically confirmed as sCHC from April 2011 to July 2019 in Lishui Central Hospital were retrospectively analyzed. The enhancement features of the lesions were mainly observed and compared to the pathological results. Then, Fisher test was used to analyze the different enhancement modes among the different dominant tumor cells types of lesion. Results: Six cases showed obvious thick-ring enhancement in the arterial phase and continuous enhancement in the following phase, whose pathology demonstrated as a circle of diffuse and mixed distribution of two types of survival tumor cells in the periphery of the lesion, with the center of the lesion mainly coagulative necrosis. One case showed obvious thick-ring enhancement in the arterial phase and filling enhancement in the following phase, whose pathology demonstrated as a circle of diffuse and mixed distribution of two types of living tumor cells in the periphery of the lesion, with the center of the lesion fibrous matrix and little coagulative necrosis. Fourteen cases showed significant entire enhancement in the arterial phase and continuous enhancement in the following phase, whose pathology demonstrated as diffuse and mixed distribution of two types of survival tumor cells in the lesion, in which fibrous matrix was not abundant, and with little or no coagulative necrotic necrosis. One case showed nodule-in-nodule enhancement, whose pathology demonstrated as migrating distribution of two types of survival tumor cells, with little fibrous matrix and no coagulative necrotic necrosis. Two cases showed reverse enhancement, whose pathology demonstrated as migrating distribution of two types of survival tumor cells, with more fibrous matrix in the ICC district than HCC district, and no coagulative necrosis in either of them. Of the 24 cases, 12 were ICC dominant, 8 were HCC dominant and 4 were proportional proximity. There was no significant difference in the enhancement performance of the proportion of sCHC (P>0.05). Conclusion: Different MR enhancement manifestations of sCHC lesions have their corresponding pathological basis.
