Intrahepatic peripheral cholangiocarcinoma in cirrhosis patients may display a vascular pattern similar to hepatocellular carcinoma on contrast-enhanced ultrasound

Authors

  • Ramón Vilana,

    Corresponding author
    1. Radiology Department, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
    • BCLC group, Department of Radiology-CDI, C/ Villarroel 170, 08036 Barcelona, Spain
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    • fax: +34 932275792.

  • Alejandro Forner,

    1. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
    2. Liver Unit, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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  • Luis Bianchi,

    1. Radiology Department, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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  • Ángeles García-Criado,

    1. Radiology Department, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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  • Jordi Rimola,

    1. Radiology Department, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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  • Carlos Rodríguez de Lope,

    1. Liver Unit, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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  • María Reig,

    1. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
    2. Liver Unit, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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  • Carmen Ayuso,

    1. Radiology Department, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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  • Concepció Brú,

    1. Radiology Department, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
    2. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
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  • Jordi Bruix

    1. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
    2. Liver Unit, Barcelona Clinic Liver Cancer (BCLC) group, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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  • Potential conflict of interest: Nothing to report.

Abstract

The aim of this study was to describe the imaging features by contrast-enhanced ultrasound (CEUS) of intrahepatic cholangiocarcinoma (ICC) in cirrhosis patients. We registered the CEUS images of cirrhosis patients with histologically confirmed ICC. In all cases magnetic resonance imaging (MRI) was done to confirm the diagnosis and/or staging purposes. A total of 21 patients met all the criteria to be included in the study. The median nodule size was 32 mm. All nodules showed contrast enhancement at arterial phase; in 10 cases it was homogeneous and in 11 cases peripheral (rim-like). All nodules displayed washout during the venous phases; it appeared during the first 60 seconds in 10 nodules, between 60-120 seconds in five cases, and in six cases after 2 minutes. Ten nodules (five larger than 2 cm) displayed homogeneous contrast uptake followed by washout and they correspond to the specific pattern of hepatocellular carcinoma according to the American Association for the Study of Liver Diseases criteria. However, none of these lesions displayed washout on MRI. Conclusion: CEUS should not be used as the sole imaging technique for conclusive hepatocellular carcinoma diagnosis and if the MRI does not display the diagnostic vascular pattern, a confirmatory biopsy is mandatory. Hepatology 2010;51:2020–2029

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