Mar 17, 1995 - assessment of resectability of hilar cholangiocarcinoma is often extensive, requiring several types of imaging. This picto- rial essay reviews.
1433
Pictorial
Imaging of Intrahepatic Cholangiocarcinoma Philippe Elliot
Soyer1’2,
David
A. Bluemke1
,
Cholangiocarcinoma: Ralph
Reichle1
,
Paul
S. Calhoun1
,
Donald
Essay
2. Hilar F. Bliss1
,
Antoine
Schemer2,
K. Fishman1
Hilar cholangiocarcinoma (also called Klatskin’s tumor) is more common than peripheral cholangiocarcinoma. Sonography, CT, MR imaging, angiography, and cholangiography can
suggest tumor
the diagnosis,
but the major issue of imaging
whether the tumor is resectable. The anatomic location of hilar cholangiocarcinoma makes resection difficult, so that surgical exploration of patients with this condition should be undertaken only when preoperative evaluation has shown a potential for curative resection. Preoperative
of resectability
of hilar
sclerosing
ensis,
and exposure
cholangitis, infection to Thomotrast [1].
by Clonorchis
sin-
with this
is to determine
assessment
primary
cholangiocarcinoma
Imaging
Features
Sonography Sonogmaphy and normal-size ation suggests
is
often extensive, requiring several types of imaging. This pictorial essay reviews the imaging features of hilar cholangiocarcinoma. The role of imaging in the preoperative planning, with specific emphasis on staging extent of disease, including hepatic and vascular involvement, Is discussed and illustrated.
A definite duplex
shows dilatation of the intrahepatic bile duct extrahepatic bile ducts (Fig. 2). This associthe diagnosis of hilar cholangiocancinoma [4].
mass is namely seen on sonograms
and
color
Doppler
examinations
[4]. Conversely,
can
provide
useful
on the status of the portal vein.
information
CT Definition
CT shows
Hilan chobangiocancinoma the liver that arises from
is a primary the epithelium
adenocarcinoma of of the intrahepatic
bile ducts, near the bifurcation of the hepatic 1 ). Twenty-five percent of cholangiocarcinomas hilam cholangiocancinoma
[1-3].
carcinoma
is also
Because
cabled
CT features
central
cholangio-
is an
(5) minimal
undifferentiated on poorly differentiated adenocancinoma, this diagnosis is made when other metastatic conditions (cobomectab, pancreatic, on ovarian adenocarcinoma) at this location have been ruled out. The occurrence of hilar cholangiocarcinoma is associated with ulcerative colitis, intrahepatic chobelithiasis, biliany papilboma, Canoli’s disease,
Received
March
17, 1995; accepted
after
revision
in 40%
2Department 1995;165:1433-1436
of Radiology,
H#{244}pital Foch,
tumor
enhancement
(50%
BP 36, 92151
© American
CT during cinoma
Suresnes
Roentgen
of cases),
and (6)
on beading
arterial
portography
in the majority
of cases
depicts but
cedex,
Ray Society
France.
Address
correspondence
hilan cholangiocar-
usually
June 20, 1995.
40 rue Worth,
036i-803X195/i656-1433
[4].
of intmahepatic bile ducts [4-6]. Although small hilam cholangiocarcinomas (
