Common CT findings of cholangiocarcinoma at King Chulalongkorn Memorial Hospital (KCMH)

Abstract

Background : We evaluated CT findings of 45 patients with cholangiocarcinomas.

Objective : To evaluate CT findings and pattern enhancement of cholangiocarcinoma at King Chulalongkorn Memorial Hospital (KCMH).

Methods : The contrast-enhanced CT images of the abdomen of 45 patients (29 males, 16 females were retrospective reviewed. The mean age of the subject was 56 years. Their age range was 26-81 years old. The subject were pathologically proven cases of cholangiocarcinoma diagnosed from 2004-2006. The CT findings were analyzed as follows: (1) location and macroscopic appearance (mass-forming, periductal infiltrating, intraductal and extrahepatic cholangiocarcinoma); (2) tumor size; (3) pattern of enhancement; (4) other associated findings, such as bile duct dilatation, vascular involvement, satellite nodules, capsular retraction, lymphadenopathy, distant metastasis, etc.

Result : In 45 patients, the tumors were classified as follows; 31 patients (68.9%) had mass-forming; 11 patients (24.4%) had periductal infiltration at the hilar region, and 3 patients (6.7%) had extrahepatic type. However, intraductal type was not identified in our study. Most of cholangiocarcinoma tumors of each type showed enhancement in the portovenous phase (77.8%) and the delayed phase (95%). Bile ducts dilatation was present in 37 of 45 patients (82.2%). Satellite nodules were found in 16 of the 45 patients (35.6%). Capsular retraction was present in 19 of 45 patients (42.2%). Regional lymph node enlargement was observed in 20 of 45 patients (44.4%). In mass-forming type and periductal type at the hilar region, vascular involvement was found in 38 of 45 patients (84.4%). Other associated findings in our study included ascites, marginal disruption with adjacent subcapsular collection, gallstones, peritoneal nodules, adrenal metastasis, pleural effusion, lung and bone metastases.

Conclusion : The most common type of cholangiocarcinomas in our study was massforming type. The pattern enhancement in the portovenous phase and the delayed phase with associated findings were suggestive of cholangiocarcinomas. Vascular involvement was common.