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Intrahepatic peripheral cholangiocarcinoma (IPCC): comparison between perfusion ultrasound and CT imaging

Il colangiocarcinoma intra-epatico periferico (IPCC): confronto tra studio perfusionale ecografico e TC

  • Abdominal Radiology Radiologia Addominale
  • Published:
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Abstract

Purpose

This study was done to compare the perfusion patterns of intrahepatic peripheral cholangiocarcinoma (IPCC) on contrast-enhanced ultrasound (CEUS) and dynamic computed tomography (CT).

Materials and methods

We retrospectively reviewed 23 histologically proven cases of IPCC. All lesions were studied by CEUS with sulfur hexafluoride-filled microbubbles coated with a phospholipid capsule, and by dynamic CT. Contrast-enhancement patterns were evaluated in the arterial phase (CEUS 10–20 s after the injection; CT 25–30 s after the injection) and in the delayed phase (CEUS 120 s after the injection; CT>2–3 min after the injection).

Results

Lesions were single in 18/23 cases (78%), single with nearby satellite lesions in 1/23 (4%) cases and multifocal with distant secondary lesions in 4/23 (17%) cases. Lesion diameter was 2–5 cm in 7/23 cases (30%), 5–7 cm in 13/23 cases (57%) and >7 cm in 3/23 (13%) cases. On CEUS, lesions were hypervascular in 16/23 cases (70%). On delayed-phase CEUS, 22/23 lesions (96%) were markedly hypoechoic. CT showed that the lesions were hypovascular in the arterial phase in 15/23 cases (66%) and hypervascular in 7/23 (30%) cases; one lesion (1/23; 4%) was isovascular. On delayed-phase CT, lesions were hyperdense in 17/23 cases (74%), hypodense in 5/23 (22%) cases and isodense in 1/23 (43%) cases.

Conclusions

Enhancement discrepancy between delayed-phase CEUS (hypoechogenicity) and CT (hyperdensity) is common semiological findings in the study of IPCC.

Riassunto

Obiettivo

Confrontare le caratteristiche perfusionali del colangiocarcinoma intra-epatico periferico (IPCC) in ecografia con mdc (CEUS) e TC dinamica.

Materiali e metodi

Analisi retrospettiva di 23 casi di colangiocarcinoma periferico istologicamente accertati. Tutte le lesioni sono state studiate con CEUS utilizzando microbolle a base di esaflururo di zolfo ricoperte da una capsula di fosfolipidi quale mezzo di contrasto e con TC dinamica. Sono state valutate le caratteristiche della impregnazione lesionale nelle fasi arteriosa (CEUS: 10–20 s dopo l’iniezione; TC: 25–30 s dopo l’iniezione) e tardiva (CEUS: 120 s dopo l’iniezione; TC>2–3 min dopo l’iniezione).

Risultati

In 18/23 (78%) la lesione era singola, in 1/23 (4%) singola con lesioni satelliti a ridosso della lesione principale e in 4/23 (17%) multifocale con lesioni a distanza rispetto alla lesione prinicipale. Le dimensioni delle lesioni erano comprese tra 2 e 5 cm di diametro in 7/23 (30%), tra 5 e 7 cm in 13/23 (57%) e superiori a 7 cm in 3/23 (13%). La CEUS ha evidenziato ipervascolarizzazione delle lesioni in 16/23 (70%). Ventidue su 23 lesioni (96%) in fase tardiva CEUS, sono risultate marcatamente ipoecogene. La TC ha evidenziato ipovascolarizzazione delle lesioni in fase arteriosa in 15/23 (66%) ed ipervascolarizzazione in 7/23 (30%); una lesione (1/23; 4%) era isovascolarizzata. In fase tardiva TC la lesione era iperdensa in 17/23 (74%) casi, ipodensa in 5/23 (22%) e isodensa in 1/23 (43%) casi.

Conclusioni

Il riscontro di una discordanza di enhancement in fase tardiva tra CEUS (ipoecogenicità) e TC (iperdensità) rappresenta frequente rilievo semeiologico nello studio del colangiocarcinoma intraepatico periferico.

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Authors and Affiliations

  1. Istituto di Radiologia, Università degli Studi di Verona, Policlinico “G.B. Rossi”, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    M. D’Onofrio, F. Vecchiato, R. Malagò, N. Faccioli, G. Zamboni & R. Pozzi Mucelli

  2. Istituto di Radiologia, Università “La Sapienza”, Roma, Italy

    V. Cantisani & P. Ricci

  3. Istituto di Radiologia, Casa di cura Pederzoli di Peschiera, Verona, Italy

    E. Barbi

  4. Istituto di Radiologia, Ospedale Maggiore, Lodi, Italy

    M. Passamonti

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  1. M. D’Onofrio
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  2. F. Vecchiato
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  3. V. Cantisani
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  4. E. Barbi
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  5. M. Passamonti
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  6. P. Ricci
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  7. R. Malagò
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  8. N. Faccioli
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  9. G. Zamboni
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  10. R. Pozzi Mucelli
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Correspondence to M. D’Onofrio.

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D’Onofrio, M., Vecchiato, F., Cantisani, V. et al. Intrahepatic peripheral cholangiocarcinoma (IPCC): comparison between perfusion ultrasound and CT imaging. Radiol med 113, 76–86 (2008). https://doi.org/10.1007/s11547-008-0225-1

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  • DOI: https://doi.org/10.1007/s11547-008-0225-1

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