Contrast-enhanced ultrasonography and enhanced CT in differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma

Abstract

Abstract: Objective To compare and analyze the value of contrast-enhanced ultrasound and enhanced CT in differentiating cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC).Methods The medical records of 69 patients diagnosed with primary liver cancer and admitted to Nantong cancer hospital from January 2020 to January 2022 were retrospectively analyzed. Patients were divided into two groups based on pathological examination: 45 patients with HCC and 24 patients with ICC. All patients underwent contrast-enhanced ultrasound and enhanced CT. The study examined the manifestations of ICC and HCC using contrast-enhanced ultrasound and enhanced CT. Specifically, the researchers compared the blood perfusion parameters [peak intensity (PI), time to peak (TTP), time to arrival (at)] of ICC and HCC in arterial phase of contrast-enhanced ultrasound, as well as the CT values of arterial phase (LAP), portal phase (PVP) and equilibrium phase (EP) of contrast-enhanced CT. The aim was to evaluate the diagnostic value of contrast-enhanced ultrasound and enhanced CT parameters in distinguishing HCC. Results In patients with ICC, the ultrasound contrast imaging showed that the percentages of intrahepatic bile duct dilatation, arterial phase ring enhancement, and hypovascular were 70.83%, 62.50%, and 70.83%, respectively, all of which were higher than those in HCC patients (40.00%, 20.00%, 40.00%, P<0.05). Similarly, the enhanced CT findings in ICC patients showed that the percentages of segmental signs, intrahepatic bile duct dilatation, and arterial phase ring enhancement were 75.00%, 70.83%, and 58.33%, respectively, all of which were higher than those in HCC patients (44.44%, 42.22%, 20.00%, P<0.05). The TTP in the ICC group was (22.28±3.71) s, which was higher than that in the HCC group [(16.75±2.83) s, P<0.05]. The EP phase CT value in the ICC group was (98.65±8.74) Hu, which was higher than that in the HCC group [(87.05±7.24) Hu, P<0.05]. TTP had a higher diagnostic efficacy for ICC than EP (P<0.05). The kappa values for the consistency of ultrasound contrast imaging and enhanced CT with pathological results in diagnosing ICC and HCC were 0.596 and 0.470, respectively. Conclusion Both contrast-enhanced ultrasound and enhanced CT can be utilized for the clinical diagnosis of ICC and HCC. However, contrast-enhanced ultrasound proves to be more effective in the diagnosis of ICC and HCC.

Key words: Cholangiocarcinoma, Hepatocellular carcinoma, Contrast-enhanced ultrasound, Enhanced CT

GE Shu, LIU Yang-yang. Contrast-enhanced ultrasonography and enhanced CT in differentiating intrahepatic cholangiocarcinoma from hepatocellular carcinoma[J]. Chinese Hepatolgy, 2023, 28(9): 1075-1078.

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