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Type:
Educational Exhibit
Keywords:
Cancer, Diagnostic procedure, Ultrasound, MR, CT, Liver, Biliary Tract / Gallbladder, Abdomen
Authors:
N. R. Ahumada, J. P. Gibbs, R. J. Méndez, F. MATUTE, C. Batz Colvée; Madrid/ES
DOI:
10.1594/ecr2014/C-2212
Conclusion
The cholangiocarcinoma can present in different ways,
and these different types have varied imaging features,
like a mass,
periductal infiltration or intraductal growth, that we must keep in mind in order to give a more accurate differential diagnosis to the clinician.
Sonography is usually the first imaging technique that suggests this diagnosis,
and the accuracy of this technique depends on the type of cholangiocarcinoma,
we can find bile duct dilation,
either extrahepatic,
intrahepatic or segmentary,
a liver mass or a bile duct dilation with castlike content.
Contrast enhanced triphasic CT,
arterial,
portal and delayed phases, is a great tool for evaluating liver masses and ductal enhancement,
providing us also with information on vascular involvement and tumor vasculature,
which help in the planning of an eventual surgery or palliative treatment .
MRI has better contrast resolution than CT,
so it would be the imaging technique of choice for evaluating intraductal lesions and MRI cholangiography is great for evaluating bile duct dilation of periductal cholangiocarcinomas.
The imaging findings can always be challenging and we must remember that there are some entities that can mimic them,
like the cases presented here,
chronic cholangitis and neuroendocrine tumors.