caa a22 4500 605492573 CHVBK 20210128100516.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s00261-015-0352-9 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0352-9 Intratumoral artery on contrast-enhanced computed tomography imaging: differentiating intrahepatic cholangiocarcinoma from poorly differentiated hepatocellular carcinoma [Elektronische Daten] [Seiji Tsunematsu, Makoto Chuma, Toshiya Kamiyama, Noriyuki Miyamoto, Satoshi Yabusaki, Kanako Hatanaka, Tomoko Mitsuhashi, Hirofumi Kamachi, Hideki Yokoo, Tatsuhiko Kakisaka, Yousuke Tsuruga, Tatsuya Orimo, Kenji Wakayama, Jun Ito, Fumiyuki Sato, Katsumi Terashita, Masato Nakai, Yoko Tsukuda, Takuya Sho, Goki Suda, Kenichi Morikawa, Mitsuteru Natsuizaka, Mitsuru Nakanishi, Koji Ogawa, Akinobu Taketomi, Yoshihiro Matsuno, Naoya Sakamoto] Aim: Differentiating intrahepatic cholangiocarcinoma (ICC) from poorly differentiated hepatocellular carcinoma (p-HCC) is often difficult, but it is important for providing appropriate treatments. The purpose of this study was to examine the features differentiating ICC from p-HCC on contrast-enhanced dynamic-computed tomography (CT). Methods: This study examined 42 patients with pathologically confirmed ICC (n=19) or p-HCC (n=23) for which contrast-enhanced dynamic CT data were available. CT images were analyzed for enhancement patterns during the arterial phase, washout pattern, delayed enhancement, satellite nodules, capsular retraction, lesion shape, and presence of an intratumoral hepatic artery, intratumoral hepatic vein, intratumoral portal vein, and bile duct dilation around the tumor, portal vein tumor thrombus, lobar atrophy, or lymphadenopathy. Results: Univariate analysis revealed the presence of rim enhancement (p=0.037), lobulated shape (p=0.004), intratumoral artery (p<0.001), and bile duct dilation (p=0.006) as parameters significantly favoring ICC, while a washout pattern significantly favored p-HCC (p<0.001). Multivariate analysis revealed intratumoral artery as a significant, independent variable predictive of ICC (p=0.037), and 15 ICCs (78.9%) showed this feature. Washout pattern was a significant, independent variable favoring p-HCC (p=0.049), with 15 p-HCCs (65.2%) showing this feature. Conclusion: The presence of an intratumoral artery in the arterial phase on contrast-enhanced dynamic CT was a predictable finding for ICC, and the presence of a washout pattern was a predictable finding for p-HCC, differentiating between ICC and p-HCC. Springer Science+Business Media New York, 2015 Intrahepatic cholangiocarcinoma nationallicence Intratumoral artery nationallicence Poorly differentiated hepatocellular carcinoma nationallicence Contrast-enhanced CT nationallicence Differential diagnosis nationallicence Tsunematsu Seiji Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Chuma Makoto Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Kamiyama Toshiya Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Miyamoto Noriyuki Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Yabusaki Satoshi Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Hatanaka Kanako Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan aut Mitsuhashi Tomoko Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan aut Kamachi Hirofumi Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Yokoo Hideki Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Kakisaka Tatsuhiko Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Tsuruga Yousuke Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Orimo Tatsuya Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Wakayama Kenji Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Ito Jun Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Sato Fumiyuki Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Terashita Katsumi Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Nakai Masato Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Tsukuda Yoko Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Sho Takuya Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Suda Goki Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Morikawa Kenichi Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Natsuizaka Mitsuteru Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Nakanishi Mitsuru Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Ogawa Koji Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Taketomi Akinobu Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut Matsuno Yoshihiro Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan aut Sakamoto Naoya Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/6(2015-08-01), 1492-1499 0942-8925 40:6<1492 2015 40 261 https://doi.org/10.1007/s00261-015-0352-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0352-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tsunematsu Seiji Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Chuma Makoto Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Kamiyama Toshiya Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Miyamoto Noriyuki Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Yabusaki Satoshi Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Hatanaka Kanako Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan aut NATIONALLICENCE 700 1- Mitsuhashi Tomoko Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan aut NATIONALLICENCE 700 1- Kamachi Hirofumi Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Yokoo Hideki Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Kakisaka Tatsuhiko Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Tsuruga Yousuke Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Orimo Tatsuya Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Wakayama Kenji Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Ito Jun Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Sato Fumiyuki Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Terashita Katsumi Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Nakai Masato Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Tsukuda Yoko Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Sho Takuya Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Suda Goki Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Morikawa Kenichi Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Natsuizaka Mitsuteru Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Nakanishi Mitsuru Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Ogawa Koji Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 700 1- Taketomi Akinobu Department of Gastroenterological Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan aut NATIONALLICENCE 700 1- Matsuno Yoshihiro Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan aut NATIONALLICENCE 700 1- Sakamoto Naoya Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15 Kita, 7 Nishi, Kita-ku, 060-8638, Sapporo, Japan aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/6(2015-08-01), 1492-1499 0942-8925 40:6<1492 2015 40 261