How to differentiate between combined hepatocellular carcinoma-cholangiocarcinoma and intrahepatic cholangiocarcinoma with rim arterial phase hyperenhancement?
To analyze and compare the differences in MRI features between combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) and intrahepatic cholangiocarcinoma (iCCA) with arterial phase peripheral enhancement, so as to provide valuable references for preoperative differential diagnosis.
Methods
Seventy cHCC-CCA patients and 74 iCCA patients confirmed by pathology were included in this study. Their contrast-enhanced MRI showed rim arterial phase hyperenhancement (Rim APHE). The differences of clinicopathological data and MRI features between cHCC-CCA and iCCA were compared. Then, the sensitivity, specificity, and area under curve (AUC) were also analyzed and compared.
Results
Seventy cHCC-CCA patients (mean age, 55.7 ± 10.6 years) and 74 iCCA patients (mean age, 61.1 ± 10.5 years) were evaluated. In this study, univariable and multivariable regression analysis showed that AFP > 20 ng/ml (OR = 5.824, p = 0.006), enhancing capsule (OR = 7.252, p = 0.001), and mosaic architecture (OR = 32.732, p < 0.001) were independent risk factors of cHCC-CCA with Rim APHE. However, only hepatic capsule retraction (OR = 0.091, p < 0.001) was an independent predictor of iCCA. In addition, combining AFP > 20 ng/ml with enhancing capsule (96.7% vs. 79.2%, p < 0.001) and/or mosaic architecture (96.4% vs. 94.7%, p < 0.001) can improve the sensitivity of differentiating cHCC-CCA (vs. iCCA) with Rim APHE.
Conclusion
The combination of elevated AFP and MRI features, such as enhancing capsule and mosaic architecture, will help in preoperative differential diagnosis of cHCC-CCA and iCCA with Rim APHE.
Graphical abstract
×
Anzeige
Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten
How to differentiate between combined hepatocellular carcinoma-cholangiocarcinoma and intrahepatic cholangiocarcinoma with rim arterial phase hyperenhancement?
verfasst von
Changwu Zhou Peng Huang Fei Wu Yuyao Xiao Chun Yang Mengsu Zeng
Freie Fahrt für Lipidsenker? Das nicht, doch mit niedrigerem Schwellenwert fürs Infarktrisiko und neuen Indikationen hat der G-BA die Verordnungs-Handbremse ein gutes Stück weit gelockert.
Wird bei Kindern mit stumpfem Trauma eine CT des Bauchraums veranlasst, sind in rund 40% der Fälle Auffälligkeiten zu sehen, die nichts mit dem Trauma zu tun haben. Die allerwenigsten davon sind klinisch relevant.
Die multiparametrische Magnetresonanztomografie hat einen festen Platz im Screening auf klinisch signifikante Prostatakarzinome. Ob auch ein biparametrisches Vorgehen ausreicht, ist in einer Metaanalyse untersucht worden.
Künstliche Intelligenz unterstützt bei der Auswertung von Mammografie-Screenings und senkt somit den radiologischen Arbeitsaufwand. Wie wirken sich diese Technologien auf die Trefferquote und die Falsch-positiv-Rate aus? Das hat jetzt eine Studie aus Schweden untersucht.