Evaluation of MRI in Diagnosing Hilar Cholangiocarcinoma

Abstract

Objective: To investigate the clinical application of MRI in the diagnosis and preoperative evaluation of hilar cholangiocarcinoma (HC). Methods: Thirty-four cases of HC were examined with 1.5T super-conduct MR unit. The plain MRI and MRCP were followed by dynamic Gd-DTPA (0.1 mmol/kg) contrast-enhanced scanning, which was repeated at 30 s intervals in the first 3 min with the patient being remained in the same position. Delayed scanning was done at 5, 8, 10, 12 and 15 min respectively. 3DDCE- MRA was performed in arterial and portal venous phase with an additional bolus injection of 15-20 mL Gd-DTPA (0.15-0.20 mmol/kg). The contrast time-signal curve of both the liver and the tumor was drawn from DCE imaging, and both arterial and portal venous phase imaging were reconstructed with MIP. MRI findings were compared with surgical findings and pathology. Results: Hilar lesion, intrahepatic ducts dilatation and disconnect of main hepatic duct were shown in all cases. Thirty-one cases had tumor-delayed enhancement. In 3D-DCE-MRA, spiral artery deformed was displayed in 6 cases, infiltration, encasement or occlusion of portal vein was displayed in 18 cases. The accuracy of assessing tumor unresectability and resectability by preoperative MRI was 95.0% (19/20) and 78.6% (11/14) respectively. The total accuracy rate of MRI assessing was 88.2% (30/34). Conclusion: All-in-one MR, including plain MR, MRCP, MR DCE and 3D-DCE-MRA, can accurately show the lesions and involvement of neighbouring tissues. It was of great value in diagnosis and preoperative evaluation of HC.