Preoperative Computed Tomography of Intrahepatic Mass-forming Cholangiocarcinomas: Morphologic Features and Enhancement Patterns Correlation with Clinicopathologic Factors and Clinical Outcomes
Keywords:
Cholangiocarcinoma, Computed tomography, Enhancement patternAbstract
Purpose: To evaluate preoperative morphologic features and enhancement patterns of intrahepatic mass-forming cholangiocarcinomas (IMCC) on CT and to determine the relationship between CT features, clinicopathologic factors, and clinical outcomes.
Materials and methods: Twenty patients with pathologically confirmed IMCC were included. Two radiologists independently evaluated the CT features and then reached consensus decisions. Histopathologic data and clinical outcomes after surgical resection were collected. Statistically significant CT parameters were identified through univariate analyse.
Results: Patients with negative preoperative CEA had longer disease free rate (DFR) than those with positive CEA (13.8 vs. 3.5 months; P = 0.014). Patients with tumors < 5 cm) had longer DFR than patients with tumors > 5 cm (16.5 vs 4.7 months; P = 0.006). Patients with
well moderately differentiated tumors demonstrated longer DFR than those with poorly differentiated tumors; P = 0.007. IMCC with daughter nodules had more frequent adjacent organ involvement at pathological examination (P = 0.005). IMCC with hepatic vein
invasion more frequently had margin involvement than those without hepatic vein invasion (P = 0.018).
Conclusion: Preoperative CEA levels, tumor sizes, daughter nodules, hepatic vein invasion, and pathological grades are significant prognostic factors of clinical outcome after surgical resection of IMCCs. Our results suggest that pre-operative CEA level and morphologic features of IMCC on CT may be useful to predict clinicopathological outcomes.
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