Differentiation between inflammatory myofibroblastic tumor and cholangiocarcinoma manifesting as target appearance on gadoxetic acid-enhanced MRI

Autor: Honsoul Kim, Ji Hye Min, Amy Inji Chang, Jisun Lee, Soon Jin Lee, Young Kon Kim
Rok vydání: 2018
Předmět:
Adult
Gadolinium DTPA
Male
medicine.medical_specialty
Gadoxetic acid
Urology
Contrast Media
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
Cholangiocarcinoma
Diagnosis
Differential
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Myofibroblasts
Intrahepatic Cholangiocarcinoma
Aged
Retrospective Studies
Radiological and Ultrasound Technology
medicine.diagnostic_test
business.industry
Gastroenterology
Magnetic resonance imaging
Middle Aged
Hepatology
Image Enhancement
Magnetic Resonance Imaging
Hyperintensity
Bile Duct Neoplasms
Homogeneous
Inflammatory pseudotumor
Female
030211 gastroenterology & hepatology
Bile Ducts
business
Nuclear medicine
medicine.drug
Arterial phase
Zdroj: Abdominal Radiology. 44:1395-1406
ISSN: 2366-0058
2366-004X
DOI: 10.1007/s00261-018-1847-y
Popis: To determine the differential features of inflammatory myofibroblastic tumor (IMT) and intrahepatic cholangiocarcinoma (ICC) manifesting as target appearance on gadoxetic acid-enhanced MRI. Twenty-seven patients with 36 IMTs (1.2–6.0 cm) and 34 patients with 34 ICCs (1.5–6.0 cm) who underwent gadoxetic acid-enhanced MRI were enrolled in this study. Two reviewers evaluated morphology, signal intensity, and enhancement features of tumors on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and gadoxetic acid-enhanced imaging. As for 32 IMTs with target appearance, IMTs most commonly demonstrated early target appearance characterized by a peripheral hypointense rim on unenhanced T1WI (n = 27, 84.4%), central enhanced area with a hypointense rim on arterial phase (AP) and portal venous phase (PVP) (n = 29, 90.6%), and transitional phase (TP) (n = 28, 87.5%). Meanwhile, most of the ICCs showed homogeneous hypointensity on T1WI (100%), a hyperenhancing rim on AP, late target appearance on TP (n = 32, 94.1%) and HBP (n = 32, 94.1%). Target appearance on DWI appearing as hyperintensity with central hypointense area was seen in 2 IMTs and 32 ICCs. On T2WI, 24 IMTs (n = 24, 75.0%) displayed central iso- and peripheral hyperintensity and 27 ICCs (84.4%) showed layered hyperintensity with either brighter or darker area in center. The remaining six IMTs with no target were observed as cystic appearing nodules (n = 3) or ill-defined hypovascular nodules (n = 2) and fibrotic mass (n = 1). IMTs often show early target appearance on unenhanced T1WI, and early dynamic phases of gadoxetic acid-enhanced MRI. Target appearance on later phases, such as TP and HBP, and DWI target appearance were commonly in ICCs, but rare in IMTs.
Databáze: OpenAIRE
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