| Objective:1.To analyze the clinical characteristics of CHC(Combined hepatocellular-cholangiocarcinoma,CHC);2.To explore the correlation between the enhancement pattern and lesion size of CHC.3.To analyze the difference between CEUS and CECT/MRI of CHC;4.To explore the role of imaging and tumor markers in the diagnosis of CHC.Methods: From July 2011 to August 2019,among the patients with CHC confirmed by histopathology in the Third Central Hospital in Tianjin,39 patients completed CEUS and CECT/MRI before liver resection or biopsy.We retrospectively reviewed the clinical data of patients and classified the enhancement pattern of CEUS and CECT/MRI.Fisher’s exact test was used to analyze the differences in enhancement pattern of CEUS and CECT / MRI between different lesion sizes and the differences in the performance of CHC between CEUS and CECT / MRI.Explore the role of imaging and tumor markers in the diagnosis of CHC.Result: 1.Among the 39 CHC patients,32(82.1%)were male,7(17.9%)were female,the mean age was(56.3±9.0)years old and 29(74.4%)were HBs Ag positive,4(10.2%)were HCV-Ab positive,29(74.4%)were cirrhosis.38 patients had AFP examination and 25(65.8%)of them found AFP increased.32 patients had CA19-9 examination and 12(37.5%)of them found AFP increased.2.On CEUS examination: CEUS presented HCC and ICC enhancement pattern.The difference in CEUS enhancement patterns between different lesion sizes is statistically significant(P=0.002).3.On CECT/MRI examination: CECT presented HCC、ICC and CHC enhancement pattern.The difference in CECT/MRI enhancement patterns between different lesion sizes is statistically significant(P<0.001).4.When CHCs ≤3.0cm,the difference between CEUS and CECT/MRI enhancement is not statistically significant(P=1);when CHCs >3.0cm,the difference between CEUS and CECT/MRI enhancement is statistically significant(P=0.015).5.The number of CHC enhancement patterns(7/25,28%)in CHC with diameter> 3 cm is greater than the number of CHC enhancement patterns(0/14)in lesions with diameter ≤3 cm(P=0.036)。 6.The diagnostic accuracy of CEUS,CECT/MRI,CEUS and CECT/MRI combined with tumor markers for CHC was 56.2%,65.6% and 75%,respectively.Conclusions: 1.CHC occurs more commonly in middle-aged or older patients,and usually accompanied with hepatitis virus infection and cirrhosis.Serum AFP and CA19-9 were increased.2.The CEUS and CECT / MRI enhancement pattern of CHC are related to tumor size.When CHCs ≤3.0cm,CEUS and CECT/MRI were mainly presented ICC enhancement patterns;when CHC >3.0cm,CEUS was mainly presented ICC enhancement patterns while CECT/MRI was mainly presented ICC or CHC enhancement patterns.3.Combining the CEUS and CECT/MRI and tumor markers can improve the accuracy of the diagnosis of CHC. |
