Acomparison of an accuracy in diagnosis of cholangiocarcinomabetween CT scan and MRI in Roi-et hospital

Abstract

             Objective : The aims of this study were to evaluate accuracy of CT scan in determine the type and extension of cholangiocarcinoma as compared to MRI in Roi-et hospital. From September 2013 to June 2015, 50 patients with cholangiocarcinomawho had underwent CT scan, and MRI were retrospectively reviewed by using PACS to assess type, extension, percentage, and imaging features. Sensitivity, specificity and accuracy of CT scan in determine the type and extension of cholangiocarcinoma were calculated.

             Results : The most common type of cholangiocarcinomawas hilar type (47.3%). Intrahepatic and extrahepatic types were 34.5% and 18.2%, respectively. 92.6 % of hilarcholangiocarcinoma were periductal type, which appeared biliary stricture, thickened enhanced wall and upstream biliary dilatation. Only 7.4% of hilarcholangiocarcinoma were intraductal type. On MRI intrahepatic cholangiocarcinoma appeared hypointense on T1-weighted images, and hyperintense on T2-weighted images. Intrahepatic cholangiocarcinoma shown moderate peripheral enhancement followed by progressive and concentric filling in the tumor in 66.6% of patients. On CT scan intrahepatic cholangiocarcinoma were also hypodensity with patterns of enhancement same as MRI. The imaging features of extrahepaticcholangiocarcinoma were focal biliary stricture with thickened enhanced wall (88.8%), asymmetric (77.7%) and abrupt (100%) narrowing, mean length of 18 mm, and mean wall thickness of 4 mm. Other findings included, vascular invasion 54%, biliary dilatation 94%, capsular retraction 20%, lobar atrophy 20%, intrahepatic metastases 48%, lymph node metastases 80%, adjacent organ invasion 26% and distant metastases 8%. The specificity and accuracy of CT scan in differentiate the type of cholangiocarcinoma were 83.3%-100.0% and 87.1%-93.5%, respectively. However CT scan had low accuracy (53.8%) in evaluated the type of hilarcholangiocarcinoma according to Bismuth-Corlette classification. In determined vascular invasion, biliary dilatation, capsular retraction, lobar atrophy, intrahepatic metastases, lymph node metastases, adjacent organ invasion and distant metastases, CT scan had high specificity (73.7%-100%) and accuracy (70.9%-100%).

            conclusion : CT scan had high specificity and accuracy in determine the type and extension of intrahepatic and extrahepaticcholangiocarcinoma, but had limitation in hilarcholangiocarcinoma.  There were typical imaging features of cholangiocarcinoma in Roi-et hospital.