ObjectiveTo comparatively analyze the image features of tumorous acute pancreatitis (T-AP) and non-tumorous acute pancreatitis (NT-AP). MethodsSixteen cases of histopathologically proven pancreatic tumors inducing acute pancreatitis and 30 cases of non-tumorous acute pancreatitis were collected, and studied their CT and MRI features. ResultsThere were 16 cases (100%) with focal nodules or masses in T-AP group and none in NT-AP group. The average innerdiameter of main pancreatic ducts in T-AP group was (9.6±6.8) mm, in which 14 cases (87.5%) were dilated. And the average innerdiameter of main pancreatic ducts in NT-AP group was (2.9±0.9) mm, in which 7 cases (23.3%) were dilated. The cases of sinistral portal hypertension (SPH), accompanying cholelithiasis and lymphadenosis between the two groups were 10 (62.5%), 3 (18.8%), 14 (87.5%), and 1 (3.4%), 25 (83.3%), 30 (100%), respectively. The occurrence of manifestation of focal nodules or masses, dilated main pancreatic ducts, SPH, and accompanying cholelithiasis were significantly different (P=0.000) between T-AP and NT-AP groups. While, the differences in enhancement pattern and the occurrence of lymphadenosis between the two groups were not significant (P > 0.05). ConclusionThe image features of T-AP are various. The application of CT and MRI could provide effective diagnostic guidelines for patients with T-AP.
ObjectiveTo assess value of preoperative clinical data and enhanced CT imaging features in predic-tion of microvascular invasion (MVI) and early recurrence (recurrence in one year) after curative resection for hepatoce-llular carcinoma (HCC). MethodsA retrospective analysis was conducted for 150 patients with HCC who underwent curative tumor resection in West China Hospital of Sichuan University from April 2014 to May 2015. The roles of preoperative CT characteristics and clinical data on MVI and early recurrence after curative tumor resection were evaluated by univariate and multivariate analyses. Resultscompared with HCC with no MVI and no early recurrence after curative resection, univariate analysis results showed that HCC with MVI and early recurrence had larger tumor size (P=0.002, P=0.005), a higher proportion of non-smooth tumor margin (P<0.001, P<0.001), and tumor multifocality (P=0.005, P=0.038), HCC with MVI had a higher proportion of incomplete tumor capsule (P=0.032), HCC with early recurrence had a higher proportion of incomplete and absence tumor capsules (P=0.038) and a faster washout on portal venous phase-the percentage attenuation ratio on the portal venous phase (P=0.049) and relative washout ratio on the portal venous phase (P=0.020) were higher. A multivariate logistic regression analysis results showed that non-smooth tumor margin (OR=7.075, P<0.001; OR=4.125, P<0.001) and tumor multifocality (OR=3.290, P=0.008; OR=2.354, P=0.047) were the independent predictors for MVI and early recurrence after curative tumor resection, HCC with early recurrence also had a faster washout on the portal venous phase (OR=1.023, P=0.017). ConclusionNon-smooth tumor margin and tumor multifocality are independent risk factors for MVI and early recurrence after curative tumor resection, and HCC with early recurrence has a faster washout on portal venous phase. Preoperative enhanced CT imaging could predict MVI and early recurrence after curative tumor resection and CT imaging findings are helpful to choose reasonable treatment and predict prognosis.
ObjectiveTo discuss the CT imaging differences between mass-forming intrahepatic cholangiocarcinoma (ICC) and poorly-differentiated hepatocellular carcinoma (HCC). MethodThe clinical and CT data of 28 patients with mass-forming ICC (mass-forming ICC group) and 27 patients with poorly-differentiated HCC (poorly-differentiated HCC group), who were confirmed by pathological diagnosis in the West China Hospital from February 2014 to August 2014, were collected and analyzed retrospectively. ResultsThe contour, margin, enhancement patterns in the arterial phase and portal vein phase of the tumor had significant differences between the mass-forming ICC group and poorlydifferentiated HCC group (P < 0.05), in other words, the lobulated shape (15/28, 53.6%), indistinct margin (17/28, 60.7%), peripheral enhancement in the arterial phase (21/28, 75.0%) and prolonged enhancement in the portal vein phase (14/28, 50.0%) were more often seen in the mass-forming ICC group, while the poorly-differentiated HCC group were mainly the round shape (17/27, 63.0%), partially well-defined margin (18/27, 66.7%), diffuse heterogeneous enhancement in arterial phase (20/27, 74.1%) and wash out in the portal vein phase (18/27, 66.7%). The presence of bile duct dilatation in the the mass-forming ICC group was significantly higher than that in the poorly-differentiated HCC group﹝57.1% (16/28) versus 14.8% (4/27), P=0.001﹞. The size and enhancement degree of lymph node in the mass-forming ICC group were significantly bigger or higher than those in the poorly-differentiated HCC group (average lymph node size: 1.7 cm versus 1.3 cm, P=0.009; average enhancement degree of lymph node: 62.6 HU versus 51.8 HU, P=0.031). ConclusionCT features, such as tumor contour, margin, enhancement characteristics, the presence of bile duct dilatation, and the size and enhancement degree of lymph node, might help for differentiating mass-forming ICC from poorly-differentiated HCC, so that more timely selection of appropriate treatment strategies would be made.