BILE-DUCT INVOLVEMENT IN HEPATOCELLULAR-CARCINOMA - MR DEMONSTRATION

Background: To determine the magnetic resonance (MR) features of hepat ocellular carcinoma (HCC) with associated bile duct involvement. Metho ds: MR examinations of six patients (mean age, 62 years) demonstrating bile duct involvement due to HCC were retrospectively reviewed and co mpared to surgical and pathologic findings. Results: Three of the tumo rs were solitary, and three were multifocal. In two patients, MR showe d direct biliary duct invasion by tumor. On T1-weighted MR images, fou r tumors were hypointense compared to the liver and two were isointens e. On T2-weighted MR images, four tumors were hyperintense, and two we re isointense, The two tumors studied with dynamic T1-weighted MR imag es obtained after intravenous administration of a gadolinium chelate, displayed enhancement similar to that of the liver. There was no evide nce of a tumor capsule on either unenhanced or enhanced MR images. Int rahepatic bile duct dilatation was seen in five patients. The extrahep atic bile duct was normal in all cases. Conclusion: Although rare, HCC should be included when considering the etiology of intrahepatic bile duct obstruction. Imaging features suggestive of the diagnosis by MR include intrabiliary tumor or bile duct obstruction with an associated hepatic mass,