Analysis of Gadoxetate disodium contrast-enhanced MRI manifestations of intrahepatic cholangiocarcinoma in patients with cirrhosis
Objective:To evaluate the manifestations of Gadoxetate disodium(Gd-EOB-DTPA)contrast-enhanced MRI in diag-nosing intrahepatic cholangiocarcinoma(ICC)in patients with cirrhosis.Methods:From June 2014 to October 2021,31 cases of ICC who had been diagnosed pathologically were reviewed in Affiliated Nantong Hospital 3 of Nantong University.All cases were underwent Gd-EOB-DTPA contrast-enhanced MRI scanning.The size,morphologic features,conventional plain scan findings,dynamic enhancement regulations and signal characteristics of hepatobiliary phase were observed.Diagnostic results were compared between two radiologists under the condition of unknown pathological results.Results:All cases were single,most of them were lobulated,7 cases were atrophy of the liver lobe,16 cases of adjacent liver capsular retraction,11 cases were accompanied by distal bile duct dilatation.Inhomogeneous high signal was seen on T2 weighted images.21 cases showed"target sign"on diffusion-weighted imaging.According to the dynamic strengthening mode,ICC was divided into clas-sic group and atypical group.Classic ICC(n=24)showed gradual or persistent enhancement,atypical ICC(n=7)showed arte-rial enhancement and washout in portal venous phase or transition phase in some areas.According to the enhancement pattern of arterial phase,it could be divided into peripheral or rim enhancement(87.1%,27/31)and complete or nearcomplete arterial enhancement(12.9%,4/31),the former ICC were more common.22 cases of ICC(70.9%)showed cloud-like signal intensity in the center with peripheral defect or target sign on hepatobiliary phase.Comparison of diagnostic results between two radiol-ogists and postoperative pathology,the accuracy and consistency of diagnosis results were very high.Conclusions:Gd-EOB-DTPA contrast-enhanced MRI is helpful for the diagnosis and differential diagnosis of ICC in patients with cirrhosis,and has important clinical value.
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