Multi-slice CT diagnosis of intrahepatic cholangiocarcinoma complicated with hepatic abscess

Objective:To analyse the CT features of the cases with intrahepatic cholangiocarcinoma complicated with hepatic abscess and to evaluate its value in the diagnosis of these cases.Methods:The CT features of 15 pathologically confirmed cases with intrahepatic cholangiocarcinoma and hepatic abscess together were retrospectively reviewed and analysed.Results:On the plain CT scans,31 lesions were found with ill defined low density.Among 31 lesions,there were 15 intrahepatic cholangiocarcinomas and 16 hepatic abscesses.Lesion invoivement of 31 lesions included left lobe of liver(n=19) and right lobe(n=12).There were 10 cases that both of intrahepatic cholangiocarcinoma and hepatic abscess involved the same hepatic lobe or segment and 5 cases that both of them involved different lobes or segments.On the enhanced CT imaging,15 intrahepatic cholangiocarcinomas were classified into four types:mass-forming type(n = 5),a nodular mass in the liver parenchyma without dilatation of the peripheral ducts;periduetal-infiltrating type(n = 4),extended longitudinally along the bile duct and formed a branchlike mass with dilatation of the peripheral ducts;mass-forming plus periductal-infiltrating type(n= 6),a nodular mass in the liver parenchyma with dilatation of the peripheral ducts;intraductal growth type(n= 0).On the enhanced CT imaging,16 hepatic abscesses were divided into three types: complete central enhancement(i.e.,entirely solid,n = 3);incomplete central enhancement subdivided into type A,which showed a small central area with poor enhancement(n = 2),and type B,which showed peripheral enhancement and a multiseptal core enhancement,suggesting a multiloculated abscess(n = 4);and no central enhancement,the so called classic appearance of a hepatic abscess,with central low attenuation and peripheral ring enhancement(n = 7).Conclusion:There are different features between intrahepatic cholangiocarcinoma and hepatic abscess on the enhanced CT scanning.Thus,CT dynamic scanning has an important value in the diagnosis of the cases with intrahepatic cholangiocarcinoma and hepatic abscess together.