Clinical application of contrast-enhanced ultrasound in the diagnosis of cholangiocarcinoma

Abstract

Objective To observe intrahepatic cholangiocarcinoma (ICC) characteristic representation using ultrasound and contrast-enhanced ultrasound (CEUS) technology, and explore its clinical application value in diagnosis of ICC. Methods Thirty-seven lesions that were pathologically confirmed for ICC were retrospectively analyzed. According to pathological types, the ultrasonographic features of these lesions were analyzed, including the location, range, echo, blood flow, and perfusion pattern under the contrast-enhanced ultrasound, and characteristic representation in different phases, so as to further study their clinical application value for diagnosis of ICC. Results Among the 37 patients, those with HBsAg(+ ) accounted for 56.76% (21/37). Ultrasound examination showed that patients with low echo lesions corresponding to middle or low differentiation in pathological types accounted for 88.89% (32/37). The other 5 cases with hyperechoic lesions corresponding to well-differentiated accounted for 11.12% (5/37). Lesions with fuzzy boundaries were 72.97% (27/37), and with clear boundaries were 27.03% (10/37). Color Doppler ultrasound showed that the lesions without blood supply accounted for 59.46% (22/37), and with a little blood flow signal 40.54% (15/37). CEUS showed in the arterial phase the ring-like enhancement accounted for 51.35% (19/37), and the whole stripped lesions with high signals accounted for 16.22% (6/37), and lesions without reinforcement accounted for 32.43% (12/37). Of 37 lesions, 25 (67.57%) appeared transient enhancement in the focal lobe of liver in early arterial phase. In portal vein phase, 16.22% (6/37) cases were seen a little contrast agent perfusion in the lesions, and the remaining 86.48% (31/37) had no perfusion. In delayed phase, all 37 cases showed contrast agents entirely exited in the lesions, which was characterized by no perfusion. Conclusions The important characteristics indexes in diagnosing ICC are lesions that appear to lack blood supply with fuzzy boundary inside the liver under the ultrasound, and lesions that show ring-like enhancement and transient enhancement in the focal lobe of liver in early arterial phase under contrast-enhanced ultrasound. On the basis of conventional ultrasound diagnosis, combination of color Doppler ultrasound with contrast-enhanced ultrasound examination can improve the accuracy of ICC diagnosis. Key words: Contrast-enhanced ultrasound; Cholangiocarcinoma