Chulalongkorn Medical Journal


Background : We evaluated CT findings of 45 patients with cholangiocarcinomas.Objective To evaluate CT findings and pattern enhancement of cholangiocarcinomaat King Chulalongkorn Memorial Hospital (KCMH).Methods : The contrast-enhanced CT images of the abdomen of 45 patients(29 males, 16 females were retrospective reviewed. The mean age of thesubject was 56 years. Their age range was 26-81 years old. The subjectwere pathologically proven cases of cholangiocarcinoma diagnosed from2004-2006. The CT findings were analyzed as follows: (1) location andmacroscopic appearance (mass-forming, periductal infiltrating, intraductaland extrahepatic cholangiocarcinoma); (2) tumor size; (3) pattern ofenhancement; (4) other associated findings, such as bile duct dilatation,vascular involvement, satellite nodules, capsular retraction,lymphadenopathy, distant metastasis, etc.Result : In 45 patients, the tumors were classified as follows; 31 patients (68.9%)had mass-forming; 11 patients (24.4%) had periductal infiltration atthe hilar region, and 3 patients (6.7%) had extrahepatic type. However,intraductal type was not identified in our study. Most of cholangiocarcinomatumors of each type showed enhancement in the portovenous phase (77.8%)and the delayed phase (95%).Bile ducts dilatation was present in 37 of 45 patients (82.2%).Satellite nodules were found in 16 of the 45 patients (35.6%). Capsularretraction was present in 19 of 45 patients (42.2%). Regional lymph nodeenlargement was observed in 20 of 45 patients (44.4%). In mass-formingtype and periductal type at the hilar region, vascular involvement wasfound in 38 of 45 patients (84.4%). Other associated findings in our studyincluded ascites, marginal disruption with adjacent subcapsular collection,gallstones, peritoneal nodules, adrenal metastasis, pleural effusion, lungand bone metastases.Conclusion : The most common type of cholangiocarcinomas in our study was massformingtype. The pattern enhancement in the portovenous phase andthe delayed phase with associated findings were suggestive ofcholangiocarcinomas. Vascular involvement was common.


Faculty of Medicine, Chulalongkorn University

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