INTRAHEPATIC CHOLANGIOCARCINOMA - MRI AND PATHOLOGICAL CORRELATION IN14 PATIENTS

Purpose: Our goal was to determine the MR features of intrahepatic cho langiocarcinoma and to correlate them with pathologic findings in a su rgical series. Method: MRI in 14 patients with intrahepatic cholangioc arcinoma who had undergone resection was reviewed. All patients had T1 - and T2-weighted SE sequences. Contrast-material-enhanced MRI was per formed in 12 cases. Comparison between findings at MRI and pathologic examination was made. Results: MRI depicted ail the lesions but one sa tellite nodule of 2 cm diameter. All lesions were hypointense relative to the liver on T1-weighted images. On T2-weighted images, the tumors were predominantly isointense or slightly hyperintense relative to li ver parenchyma in nine cases (64%) and were strongly hyperintense in f ive cases (36%). Central hypointense areas or bands were seen in eight cases. No capsule was detected. On contrast-enhanced MR studies, all lesions bad progressive and concentric filling with contrast material. Associated findings such as vascular encasement, focal liver atrophy, or dilatation of intrahepatic bile ducts were observed in 10 cases (7 1%). Comparison with pathologic examination revealed that lesion signa l intensity on T2-weighted MR images was due mostly to the amount of f ibrosis, necrosis, and mucous secretion within the lesion. The nine is ointense or slightly hyperintense lesions contained abundant fibrosis and had a low content of mucous secretion or necrosis, whereas the fiv e hyperintense lesions contained low or moderate fibrosis and prominen t mucous secretion and/or necrosis. Conclusion: Our study suggests tha t the MR features of intrahepatic cholangiocarcinoma are well correlat ed with pathologic findings, but are nonspecific. Associated findings may strengthen the diagnosis of intrahepatic cholangiocarcinoma at MRI .