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Intrahepatic Mass-Forming Cholangiocarcinoma

Relationship Between Computed Tomography Characteristics and Histological Subtypes

Nam, Ju Gang, MD*; Lee, Jeong Min, MD*†‡; Joo, Ijin, MD*; Ahn, Su Joa, MD*; Park, Jin Young, MD§; Lee, Kyoung Bun, MD*; Han, Joon Koo, MD*†

Journal of Computer Assisted Tomography: May/June 2018 - Volume 42 - Issue 3 - p 340–349
doi: 10.1097/RCT.0000000000000695
Abdominal Imaging

Objective The aim of this study was to determine the value of multi–detector row computed tomography (MDCT) in differentiating the small-duct (SD) and large-duct (LD) types of intrahepatic mass-forming cholangiocarcinomas (IMCCs) and predicting patient prognosis.

Methods The 4-phase MDCT image findings of 82 patients with surgically confirmed IMCCs (60 SD-type and 22 LD-type IMCCs) were compared between 2 types using univariate and multivariate analyses. Overall survival rates for 78 patients with available information were compared using the Kaplan-Meier method.

Results Arterial hyperenhancement, round or lobulated contour, and lack of bile duct encasement were significant MDCT features suggesting the SD type, and lymph node enlargement was significantly associated with the LD type (all P's < 0.05). The presence of those 3 SD-type-suggestive features (MDCT-suggested SD type) demonstrated high specificity (90.9% [20/22]) in differentiating the SD type. Patients of MDCT-suggested SD type without lymph node enlargement (n = 24) demonstrated significantly better overall survival than other groups.

Conclusions Preoperative MDCT features of IMCCs can help differentiate the SD and LD types and predict patient prognosis.

From the *Department of Radiology, Seoul National University Hospital;

Department of Radiology, Seoul National University College of Medicine; and

Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul; and

§Department of Radiology, Dongnam Institution of Radiological and Medical Sciences, Busan, South Korea.

Received for publication May 13, 2017; accepted September 7, 2017.

Correspondence to: Jeong Min Lee, MD, Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 03080, Korea (e-mail:

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