1133: Contrast-Enhanced Real-Time Harmonic Gray Scale Ultrasound Findings of Peripheral Intrahepatic Cholangiocarcinoma

Abstract

To characterize the contrast-enhanced real-time harmonic gray scale ultrasound (CEUS) findings of peripheral intrahepatic cholangiocarcinoma (ICC) and to access the usefulness of CEUS in the diagnosis of ICC. Retrospective analysis of 33 patients with ICC who had undergone both preoperative CEUS. Sonographic examinations were performed with Technos DU8 and Philips IU22 ultrasound instruments and ultrasound contrast agent SonoVue. All ICC lesions enhanced in the arterial phase with an initial time of 14.59s±3.77s(5s-20s) and a peak enhancement time of 21.39s±5.00s(10s-30s). The time of lesions displaying isoechoic and hypoechoic comparing with the hepatic parenchyma were 29.84s±7.69s(14s-52s) and 40.13s±15.55s(20s-90s), respectively. Then all lesions presented hypoechoic in the portal and the late phase. Of the 33 patients,16 (48.5%) cases showed whole-lesion enhancement and 17 (51.5%) cases showed rim-like or thick bandlike enhancement. There were 63.6%(21/33) cases showing progressive dendritic and concentric filling of the contrast agent and 81.8%(27/33)cases showing heterogeneous enhancement during the peak enhancement. Of all patients, 51.5% (17/33) cases presented lobular appearance during the CEUS examination especially in the portal phase and parenchyma phase. The diagnostic accuracy of CEUS was 87.9% (29/33) if the diagnostic feature included early wash-in and wash-out, progressive dendritic enhancement and/or heterogeneous enhancement. There are some specific findings on CEUS which is useful in the diagnosis and differential diagnosis of this disease.