Imaging features on contrast-enhanced ultrasound and pathological analysis of combined hepatocellular-cholangiocarcinoma

Abstract

Objective To evaluate the correlation between the imaging features on contrast-enhanced ultrasound (CEUS) and pathological characteristics of combined hepatocellular-cholangiocarcinoma (CHC). Methods Forty patients with pathologically proven hepatic CHC were evaluated, the CEUS imaging findings and pathological characteristics of CHC were retrospectively analyzed. Results On CEUS, peripheral irregular rim-like enhancement, diffuse heterogeneous enhancement and diffuse homogeneous enhancement were illustrated in 13(32.5%), 21(52.5%) and 6(15.0%) lesions, respectively. Pathological findings showed that HCC-predominance, CC-predominant, and similar proportions of the two components were illustrated in 16(40.0%), 19(47.5%) and 5(12.5%) cases, respectively. The presence of necrosis were illustrated in 28(70.0%) cases. On CEUS, when the enhancement pattern was peripheral irregular rim-like enhancement, CC-predominance and necrosis were presented in 11(84.6%) and 10(76.9%) cases, respectively. When the enhancement pattern was diffuse heterogeneous enhancement, CC-predominance and necrosis were presented in 11(52.4%) and 18(85.7%) cases, respectively. When the enhancement pattern was diffuse homogeneous enhancement, HCC-predominance and necrosis were presented in 4(66.6%) and 0(0%) cases, respectively. There were significant differences in relative proportion of HCC, CC components and tumor necrosis among the three types of enhancement pattern on CEUS (P=0.009 and P 5 cm, peripheral irregular rim-like enhancement, diffuse heterogeneous enhancement and diffuse homogeneous enhancement were illustrated in 8, 18 and 1 cases, respectively. There were significant differences in the three types of enhancement pattern between lesion size of ≤5 cm and >5 cm on CEUS (P=0.006). Conclusions The imaging findings of CHC on CEUS depends on the relative proportions of HCC and CC component and on size-dependent patterns. Key words: Contrast-enhanced ultrasound; Liver neoplasms; Combined hepatocellular-cholangiocarcinoma