The Value Of MR Imaging In The Mass-forming Intrahepatic Cholangiocarcinoma

Objective To Analyze the MRI features of mass-forming intrahepatic cholangiocarcinoma (ICC),and to investigate the value of MRI for diagnosis of ICC.Materials and methods50cases of ICC patients′MRI imaging which were confirmed by pathology were analysised, all patients had PhilipsAchieva1.5T MR or Siemens Verio3.0T scanner MR conventional scan+dynamic enhancement and DWI examination. Observated and analysised the MRI plain and dynamic enhancement characteristics of the lesion, the images of ICC features such as the location, shape, size, edge, signal intensity, enhancement mode, and wheher there were bile duct dilatation, liver capsule shrinkage, hepatic lobe atrophy, vascular invasion, tumor metastasis, lymph node metastasis of peritoneal or/and hepatic portal area were stdudied.ADC value was Measured in the lesion edge part is obvious enhancement in arterial phase, the central region and delayed enhancement lesion and normal liver tissue of the same patient.Results (1) MR conventional scaning, all lesions showed slightly low T1, slightly high or high T2signal evenly or unevenly,some of which found punctuate or patchy high signal in T2. Among which there were8cases found stellated or patchy hypointense in long T2hyperintense.(2)25cases of lesions edge were found thick/thin ring or rosette-like enhancement in arterial phase, in The portal phase and delayed phase,contrast agent was filled gradually to the focus, enhancement range increased, showing heterogeneous patchy enhancement, partly grid shaped reinforcement. The lesions of19cases of arterial phase was not uniform in mild to moderate patchy enhancement, and the enhancement range increased in delayed phase. The lesions of4cases showed no enhancement in the arterial phase, and were found progressive enhancement in Venous&delay period..2patients were found had significantly homogeneous enhancement in arerial phase, and was still high signal rather than decreased in delayed phase.(3)All lesions showed slightly high or high T2signal evenly or unevenly on DWI.ADC value of the lesion edge part which is obvious enhancement in arterial phase, the central region which delayed enhancement lesion and normal liver tissue of the same patient was （1.05±0.24）×10－３mm２/s、（1.56±0.28）×10－３mm２/s、（1.29±0.15）×10－３mm２/s，respectively （P＜0.05）.Conclusion Stellated or patchy hypointense in long T2hyperintense, borders of lesions were early significantly enhanced and signal declined on the advanced stage; borders of lesions were early significantly enhanced presented hyperintense on DWI and hypointense on ADC map. Thoses characteristics in the MRI imaging of Mass type ICC. MRI has important clinical value in the diagnosis of ICC, and DWI has the reference value in the differential diagnosis of ICC.