ULTRASOUND & CT PICTURES OF CHOLANGIOCARCINOMA

Abstract

Our hospital, Srinagarind hospital, is located in the highest prevalence area of Cholangiocarcinoma (CHCA). The aim of this study is to present the findings of 110 ultrasound and 49 conventional CT images of 132 cases with histopathologically proven CHCA seen during 1991-1997. There were 2 major types; peripheral type 105 cases (US & CT = 22, US only = 65 and CT only = 18 ); extrahepatic type 27 cases (US & CT = 5, US only = 18 and CT only = 4). The peripheral type was divided into nodular and infiltrative forms. The nodular form was the most common US finding ; solitary mass (95.12%), large size > 5 cm. (71.5%), ill-defined border (53.65%), hyperechogenicity (68.29%) and 23.17% of the cases had peripheral halo. The CT pictures were ill -defined hypodense mass with minimal peripheral enhancement. Most tumors located at posterior segment of the right lobe of liver. Peritumoral bile duct dilatation (41.46% by US, 52.5% by CT) was a useful finding in helping to distinguish CHCA from the other liver tumors. The infiltrative form was much less common (5 cases), can not be differentiated from hepatocellular carcinoma or liver metastases. The extrahepatic type CHCA (27 cases) was commonly located at hepatic duct confluence. The hilar mass could either be visualized or non — visualized.