Comparison of imaging features of intrahepatic mass-forming cholangiocarcinoma on gadoxetic acid-enhanced MR imaging with and without chronic liver disease

Abstract

Objectives: To evaluate the differences in gadoxetic acid-enhanced MR imaging features of intrahepatic mass-forming cholangiocarcinomas (ICCs) between in patients with and without chronic liver disease (CLD). Methods: Sixty-five patients (M:F=39:26, mean age, 63 [range, 35-80]) with ICCs who underwent preoperative gadoxetic acid-enhanced MRI retrospectively formed our study population. Among them, histopathology of the background liver revealed chronic hepatitis or liver cirrhosis in 20 patients, and no such diseases in 45 patients. Three observers independently reviewed imaging findings including (1) morphology; (2) pattern of enhancement; (3) appearance of T2-weighted image and diffusion weighted image. Statistically significant factors by univariable analyses (Chi-square test, Fisher’s exact test or Mann-Whitney test) entered into multivariable analysis performed using logistic regression model. Results: Univariable analyses revealed that peripheral location and proportion of arterial enhancement >20% of the tumor were significantly more frequent, although peritumoral bile duct dilatation and diffuse bile duct dilatation were significantly less frequent in ICCs in CLD patients than those without CLD. On multivariable analysis, lack of peritumoral bile duct dilatation (P = .028, B = 1.721, odds ratio (OR) = 5.589) and proportion of arterial enhancement >20% (P = .028, B = 1.552, OR = 4.719) turned out to be the only independently significant differential feature. Conclusion: ICCs arising in CLD patients more frequently show large area of arterial enhancement on gadoxetic acid-enhanced MR imaging and no peritumoral bile duct dilatation on T2-weighted MR image as compared to those developed in patients without CLD.