HILAR CHOLANGIOCARCINOMAS - T2-WEIGHTED SPIN-ECHO AND GADOLINIUM-ENHANCED FLASH MR-IMAGING

PURPOSE: To investigate the use of magnetic resonance (MR) imaging wit h dynamic gadopentetate dimeglumine enhancement in hilar cholangiocarc inoma. MATERIALS AND METHODS: Twenty-four patients (14 men, 10 women; aged 27-78 years; mean age, 51 years) with hilar cholangiocarcinoma un derwent TZ-weighted spin-echo MR imaging in the axial plane and multis ection, breath-hold, fast low-angle shot (FLASH) MR imaging in the cor onal oblique plane before and at 30, 60, 90, and 120 seconds after bol us injection of gadopentetate dimeglumine. Morphologic features were r ecorded, and contrast medium enhancement characteristics and contrast- to-noise ratios were calculated for each sequence. RESULTS: All the le sions were hyperintense on T2-weighted spin-echo images and hypointens e on FLASH images. On dynamic gadolinium-enhanced images, progressive heterogeneous enhancement was seen in all patients. Intrahepatic ducta l dilatation was present in every patient. Intraluminal components wer e seen in 11 patients, lobar atrophy in 12, and segmental portal venou s occlusion or stenosis in 13. Satellite lesions were present in four patients, and hilar lymph nodal enlargement in 11. Contrast-to-noise r atios were statistically significantly higher on T2-weighted spin-echo images than on all other images. CONCLUSION: Hilar cholangiocarcinoma s have consistent enhancement and morphologic features that can be dem onstrated with dynamic contrast-enhanced MR imaging.