To describe the clinical, laboratory, and magnetic resonance imaging (MRI) characteristics of small-duct type intrahepatic cholangiocarcinoma.
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Abstract
Objective: To describe the clinical, laboratory, and magnetic resonance imaging (MRI) characteristics of small-duct type intrahepatic cholangiocarcinoma.
Materials and Methods: A retrospective cross-sectional descriptive study including 30 patients diagnosed with small-duct type intrahepatic cholangiocarcinoma at Bach Mai Hospital from January 2021 to November 2025.
Results: The mean age was 57.7 ± 10.7 years, with the highest proportion in the 50–70 age group (66.7%); males accounted for 56.7%. Patients were often asymptomatic (43.3%), followed by abdominal pain (33.3%) and jaundice (16.7%). Elevated CA 19-9 was observed in 30.0%, and HBsAg positivity in 33.3%.
On MRI, the mass-forming type was predominant (96.7%), with tumor size ≥5 cm in 53.3%, well-defined margins in 73.3%, and capsular retraction in 60.0%. Lesions were hypointense on T1-weighted imaging (93.3%), hyperintense on T2-weighted imaging (96.7%), and showed diffusion restriction (100%). The “target sign” was observed in 36.7% on T2-weighted imaging and 53.3% on diffusion-weighted imaging. Characteristic enhancement patterns included arterial phase peripheral rim enhancement (83.3%) and progressive enhancement in the portal venous phase (93.3%); in the delayed phase, there was progressive central enhancement (76.7%) and persistent enhancement (20.0%), while washout was rare (3.3%). Vascular invasion was observed in 3.3% and lymph node metastasis in 30.0%; most cases showed no biliary dilatation (83.3%).
Conclusion: Small-duct type intrahepatic cholangiocarcinoma presents with nonspecific clinical and laboratory findings. MRI features play an important role in guiding the diagnosis.
Keywords: small-duct intrahepatic cholangiocarcinoma; magnetic resonance imaging; enhancement pattern; target sign.
Keywords
small-duct intrahepatic cholangiocarcinoma, magnetic resonance imaging, enhancement pattern, target sign
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References
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