Values of MRI Imaging Presentations in the Hepatobiliary Phase, DWI and T2WI Sequences in Predicting Pathological Grades of Intrahepatic Mass-Forming Cholangiocarcinoma

Li-Hong Xing; Li-Yong Zhuo; Jia-Ning Wang; Yan Zhang; Feng-Ying Zhu; Chu Wang; Xiao-Ping Yin; Bu-Lang Gao

doi:10.3389/fonc.2022.867702

Values of MRI Imaging Presentations in the Hepatobiliary Phase, DWI and T2WI Sequences in Predicting Pathological Grades of Intrahepatic Mass-Forming Cholangiocarcinoma

Front Oncol. 2022 Jun 7:12:867702. doi: 10.3389/fonc.2022.867702. eCollection 2022.

Authors

Li-Hong Xing¹, Li-Yong Zhuo², Jia-Ning Wang², Yan Zhang³, Feng-Ying Zhu², Chu Wang⁴, Xiao-Ping Yin², Bu-Lang Gao²

Affiliations

¹ Affiliated Hospital of Hebei University/ School of Clinical Medicine of Hebei University, Baoding, China.
² Computed Tomography (CT)/Magnetic Resonance Imaging (MRI) Room, Affiliated Hospital of Hebei University, Baoding, China.
³ Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, China.
⁴ Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.

Abstract

Objective: To retrospectively investigate the value of various MRI image menifestations in the hepatobiliary phase (HBP), DWI and T2WI sequences in predicting the pathological grades of intrahepatic mass-forming cholangiocarcinoma (IMCC).

Materials and methods: Forty-three patients of IMCCs confirmed by pathology were enrolled including 25 cases in well- or moderately-differentiated group and 18 cases in poorly-differentiated group. All patients underwent DWI, T2WI and HBP scan. The Chi square test was used to compare the differences in the general information. Logistic regression analysis was used to analyze the risk factors in predicting the pathological grade of IMCCs.

Results: The maximal diameter of the IMCC lesion was < 3 cm in 11 patients, between 3 cm and 6 cm in 15, and > 6 cm in 17. Sixteen cases had intrahepatic metastasis, including 5 in the well- or moderately-differentiated group and 11 in the poorly-differentiated group. Seventeen (39.5%) patients presented with target signs in the DWI sequence, including 9 in the well- or moderately-differentiated group and 8 in the poorly-differentiated group. Twenty (46.5%) patients presented with target signs in the T2WI sequence, including 8 in the well- or moderately-differentiated group and 12 in the poorly-differentiated group. Nineteen cases (54.3%) had a complete hypointense signal ring, including 13 in the well- or moderately-differentiated group and 6 in the poorly-differentiated group. Sixteen (45.7%) cases had an incomplete hypointense signal ring, including 5 in the well- or moderately-differentiated group and 11 in the poorly-differentiated group. The lesion size, intrahepatic metastasis, T2WI signal, and integrity of a hypointense signal ring in HBP were statistically significantly different between two gourps. T2WI signal, presence or non-presence of intrahepatic metastasis, and integrity of hypointense signal ring were the independent influencing factors for pathological grade of IMCC.

Conclusion: Target sign in T2WI sequence, presence of intrahepatic metastasis and an incomplete hypointense-signal ring in HBP are more likely to be present in poorly-differentiated IMCCs.

Keywords: hepatobiliary phase; intrahepatic mass-forming cholangiocarcinoma; marginal low signal ring; pathological grade; target sign.