Comparative Study On The Enhanced CT Diagnosis And Pathology Of Intrahepatic Cholangiocarcinoma

Objective:By analyzing enhanced CT characteristics of Intrahepatic Cholangiocarcinoma(hereinafter referred to as ICC),it has studied the corelation between enhancement features of ICC and those of its pathology,so as to improve recognition of CT and pathological characteristics of ICC.Method: It was conducted a retrospective analysis of 50 cases seeking medical service in Hepato-Biliary-Pancreatic Surgery of Liaoning Cancer Hospital & Institute from January 2014 to June 2017,all confirmed as ICC through consultations by Pathology Department.They went through multiphase dynamic contrast-enhanced scanning before surgical treatment,and could be divided into hepatitis group and non-hepatitis group in accordance with the patients’ medical history and laboratory results.Also the cases could fall into < 3cm group,3-6cm group and > 6cm group upon the maximum diameter of lesions,into well,medium and poorly differentiated groups in line with the postoperative pathological differentiation,as well as into mass,infiltrative stenosis and intraductal-growing types based on the pathomorphological classification.Statistical means was adopted to compare the differences in tumor enhancement patterns among the groups after a probe into the pathological enhancement features.Result: By observing the multiphase dynamic contrast-enhanced scanning of ICC,the cases could be classified into the following four types: Type I: ring—like and garland—like marginal enhancement in early phase,and as time goes by centripetal progressive strengthening continuously;Type Ⅱ: whole mass persistently progressive enhancement with slight uniformity or non-uniformity;Type III: mild to moderate marginal enhancement,non-enhanced in most inner,or diffused distribution slight enhancement in great non-enhanced area;Type IV: obvious enhanced at arterial phase,after then decrease.In the hepatitis group,there were 10,4,3,and 6 cases falling intoType I to IV respectively,and the number was 21,0,2 and 4 for non-hepatitis group.The difference was not statistically significant(p=0.051).Apart from that,there were 3,1,5,and 3 cases of the mentioned four enhancement types in the group of tumors with a maximum diameter of <3 cm(12 cases),and 16,1,0,and 2 cases in the 3-6 cm group(19 cases),as well as 12,2,0,and 5 cases in the >6 cm group(19 cases)separately,and the difference was statistically significant(p<0.05).Furthermore,the well and medium differentiated group(24 cases)consisted of 16,2,3,and 3 cases of the Type I to IV,and the poorly differentiated group(26 cases)of 15,2,2 and 7 cases.The enhancement difference of cases with various pathological differentiation was not statistically significant either(p=0.625).Additionally,in the pathological mass group(25 cases),enhancement Type I to IV claimed 19,2,2 and 2 cases respectively,and infiltrative stenosis group(12 cases)included 9,1,2,and 0 cases,while intraductal-growing group(13 cases)had 3,1,1 and 8 cases.There was statistically significance in the difference(p< 0.05).Conclusion: From the above,the CT enhancement modes of ICC vary greatly.Therefore,by virtue of comparing the enhanced features of CT imaging,it has been unveiled that the CT enhancement type of ICC is related to pathomorphological classification and lesion size,not to pathological differentiation.