Application of Gd-EOB-DTPA-enhanced MRI in the diagnosis of cholangiocarcinoma

Objective: To describe the gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI appearance of cholangiocarcinoma. Methods: MRI of 25 patients with pathologically-proven cholangiocarcinomas was reviewed. The MRI sequences included unenhanced T₁- and T₂-, and Gd-EOB-DTPA-enhanced T₁-weighted images in the arterial, venous, hepatocellular and biliary phases. The contour, location, signal intensities and enhancement patterns of the tumors, degree of bile duct dilatation and mural thickening were analyzed. The total serum bilirubin levels of all patients were also recorded. Results: Both exophytic (10) and infiltrative (10) tumors showed gradual centripetal contrast enhancement in the arterial and venous phases and became hypointense in the hepatocellular and biliary phases. The polypoid tumors (2) were homogeneously enhanced in the arterial and venous phases, and hypointense in the hepatocellular phase. Three tumors had two or more of the contrast enhancement patterns. The biliary tree was clearly depicted in the biliary phase on 12 patients with normal bilirubin levels ≤ 22 μ mol/Land was obscured on 13 patients with elevated bilirubin > 22 μ mol/L. Conclusions: Cholangiocarcinomas have variable appearance on Gd-EOB-DTPA-enhanced MRI. The biliary phase of Gd-EOB-DTPA-enhanced MRI reflects the biliary function. (authors)