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Imaging features and diagnostic value of enhanced CT and MRI in elderly patients with combined hepatocellular and cholangio carcinoma |
XIAO Zhifeng1 YANG Zhiyong1 QIAN Xiaojian1 SUN Rong1 JIANG Yanli1 XIAO Yichun2▲ |
1.Department of Radiology, Rugao Hospital Affiliated to Nantong University Rugao People’s Hospital, Jiangsu Province, Rugao 226500, China;
2.Department of Nuclear Medicine, Wuxi People’s Hospital, Jiangsu Province, Wuxi 214000, China
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Abstract Objective To explore the imaging features and diagnostic value of liver enhanced CT and MRI in elderly patients with combined hepatocellular and cholangio carcinoma (cHCC-CC). Methods From October 2018 to September 2020, 98 elderly patients suspected to be cHCC-CC admitted to Rugao People’s Hospital, Jiangsu Province were selected as the research subjects, all patients underwent CT and MRI examinations. CT and MRI imaging features of elderly patients with cHCC-CC were analyzed. Pathological results as the gold standard, the diagnostic value of CT, MRI, and their combination in elderly patients with cHCC-CC was analyzed. Results Among the 98 elderly patients suspected to be cHCC-CC, 89 cases were cHCC-CC patients. CT plain scan showed that the liver contour was unstructured, wavy, with increased volume and uneven density, and the tumor presented mixed density or low density; plain MRI showed mosaic signs. The sensitivity of liver enhanced CT, MRI, and their combination in the diagnosis of elderly cHCC-CC was 77.53%, 92.13%, and 97.75%, respectively; the specificity was 66.67%, 77.78%, and 88.89%, respectively; the accuracy was 76.53%, 90.81%, and 96.94%, respectively. Conclusion The combination of enhanced CT and MRI in the diagnosis of cHCC-CC in the elderly is effective.
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[1] Sciarra A,Park YN,Sempoux C. Updates in the diagnosis of combined hepatocellular-cholangiocarcinoma [J]. Hum Pat- hol,2020,96(12):48-55.
[2] Peng JB,Peng YT,Lin P,et al. Differentiating infected focal liver lesions from malignant mimickers:value of ultrasound-based radiomics [J]. Clin Radiol,2022,77(2):104- 113.
[3] Schizas D,Mastoraki A,Routsi E,et al. Combined hepatocellular-cholangiocarcinoma:an update on epidemiology,classification,diagnosis and management [J]. Hepatobiliary Pancreat Dis Int,2020,19(6):515-523.
[4] Ramai D,Ofosu A,Lai JK,et al. Combined hepatocellular cholangiocarcinoma:a population-based retrospective Stu- dy [J]. Am J Gastroenterol,2019,114(9):1496-1501.
[5] 张瑜,刘秀峰,秦叔逵,等.混合型肝癌的临床特征和预后分析[J].临床肿瘤学杂志,2019,212(8):71-75.
[6] 侯键.医学影像学[M].北京:中国中医药出版社,2013:43-45.
[7] 石木兰.肿瘤影像学(精)[M].北京:科学出版社,2006:28-31.
[8] 孙青,张成琪.肿瘤影像学与病理学诊断[M].北京:人民军医出版社,2013:334.
[9] Joseph NM,Tsokos CG,Umetsu SE,et al. Genomic profiling of combined hepatocellular-cholangiocarcinoma reveals similar genetics to hepatocellular carcinoma [J]. J Pathol,2019,248(2):164-178.
[10] Liu X,Khalvati F,Namdar K,et al. Can machine learning radiomics provide pre-operative differentiation of combined hepatocellular cholangiocarcinoma from hepatocellular carcinoma and cholangiocarcinoma to inform optimal treatment planning [J]. Eur Radiol,2021,31(1):244-255.
[11] Ishii T,Ito T,Sumiyoshi S,et al. Clinicopathological features and recurrence patterns of combined hepatocellular-cholangiocarcinoma [J]. World J Surg Oncol,2020,18(1):319-324.
[12] Krishna M. Pathology of cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma [J]. Clin Liver Dis,2021, 17(4):255-260.
[13] Su YL,Ng CT,Jan YH,et al. Remarkable response to olaparib in a patient with combined hepatocellular-cholangiocarcinoma harboring a biallelic brca2 mutation [J]. Onco Targets Ther,2021,14(28):3895-3901.
[14] Kim TH,Kim H,Joo I,et al. Combined hepatocellular- cholangiocarcinoma:changes in the 2019 world health organization histological classification system and potential impact on imaging-based diagnosis [J]. Korean J Radiol,2020,21(10):1115-1125.
[15] Malone CD,Gibby W,Tsai R,et al. Outcomes of yttrium-90 radioembolization for unresectable combined biphenotypic hepatocellular-cholangiocarcinoma [J]. J Vasc Interv Radiol,2020,31(5):701-709.
[16] Wang X,Wang W,Ma X,et al. Combined hepatocellular- cholangiocarcinoma:which preoperative clinical data and conventional mri characteristics have value for the prediction of microvascular invasion and clinical significance [J]. Eur Radiol,2020,30(10):5337-5347.
[17] Anysz-Grodzicka A,Podgorska J,Cieszanowski A. State-of- the-art Mr Imaging of Uncommon Hepatocellular Tumours:Fibrolamellar Hepatocellular Carcinoma and Combined Hep- atocellularcholangiocarcinoma [J]. Curr Med Imaging Rev,2019,15(3):269-280.
[18] Wang Y,Yang Q,Li S,et al. Imaging features of combined hepatocellular and cholangiocarcinoma compared with those of hepatocellular carcinoma and intrahepatic cholangiocellular carcinoma in a chinese population [J]. Clin Radiol,2019,74(5):401-407.
[19] Granata V,Fusco R,Venanzio SS,et al. Diagnostic performance of LI-RADS in adult patients with rare hepatic tumors [J]. Eur Rev Med Pharmacol Sci,2022,26(2):399-414.
[20] 刘英娜.混合型肝癌的CT及MRI影像学表现分析[J].中国CT和MRI杂志,2020,18(2):88-91.
[21] Guo W,Pang Y,Yao L,et al. Imaging fibroblast activation protein in liver cancer:a single-center post hoc retrospective analysis to compare [68Ga]Ga-FAPI-04 PET/CT versus MRI and [18F]-FDG PET/CT [J]. Eur J Nucl Med Mol Imaging,2021,48(5):1604-1617.
[22] Tsili AC,Alexiou G,Naka C,et al. Imaging of colorectal cancer liver metastases using contrast-enhanced US,multidetector CT,MRI,and FDG PET/CT:a meta-analysis [J]. Acta Radiol,2021,62(3):302-312.
[23] Shao L,Wang X,Yu Y,et al. Comparative analysis of the efficacy and accuracy of magnetic resonance imaging(MRI)and contrast-enhanced CT for residual and new lesions after transcatheter arterial chemoembolization(TACE)in patients with primary liver cancer [J]. Transl Cancer Res,2021,10(8):3739-3747.
[24] Rahimi A,Khalil A,Faisal A,et al. CT-MRI Dual Information Registration for the Diagnosis of Liver Cancer:A Pilot Study Using Point-based Registration [J]. Curr Med Imag- ing,2022,18(1):61-66.
[25] Anderson MA,Dhami RS,Fadzen CM,et al. CT and MRI features differentiating mucinous cystic neoplasms of the liver from pathologically simple cysts [J]. Clin Imaging,2021, 76(9):46-52.
[26] M Cunha G,Fowler KJ,Roudenko A,et al. How to Use LI- RADS to Report Liver CT and MRI Observations [J]. Radiographics,2021,41(5):1352-1367. |
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