Analysis of the use ultrasound in the complex diagnosis of cholangiocarcinoma


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Abstract

Objective - to determine the role of ultrasound in the diagnosis of cholangiocarcinoma. Material and methods. Ultrasound examination conducted in 120 cholangiocarcinoma patients. The results were confirmed by data from other research methods, biopsy, surgical palpation and histopathological examination of the resected material. Results. The most difficult is to diagnose tumors of the distal portions of common bile duct. Sensitivity of ultrasound, X-ray CT, MRI, surgical evaluation in the diagnosis of cholangiocarcinoma was: in intrahepatic type - 100%, 100%, 100%, 100%; hilus type - 69%, 75%, 86%, 92%; distal type - 37%, 42%, 69%, 80%. Ultrasound found no evidence of intrahepatic CCA semiotic signs that would distinguish it from other liver cancers. The features of infiltrative tumor growth bile ducts - hyperechoic structure infiltration along the outer contour of the ducts, or hypoechoic structure infiltration at the thickening of the walls of the ducts. The ultrasonic semiotics of modified metastatic lymph nodes has been developed. Conclusion. Ultrasound showed highly informative diagnostic ultrasound in determining the expansion of the bile ducts; the tumor has spread to the liver and lymph nodes. Recommended to extend indications for intraoperative ultrasonography with extrahepatic cholangiocarcinoma to delineate tumor lesions ducts.

About the authors

Tat’yana Yu. Danzanova

N.N. Blokhin Russian Cancer Research Center

Email: danzanova@yandex.ru
MD, Phd 115478, Moscow, Russian Federation

G. T Sinyukova

N.N. Blokhin Russian Cancer Research Center

115478, Moscow, Russian Federation

P. I Lepedatu

N.N. Blokhin Russian Cancer Research Center

115478, Moscow, Russian Federation

N. E Kudashkin

N.N. Blokhin Russian Cancer Research Center

115478, Moscow, Russian Federation

References

  1. Blechacz B., Komuta M., Roskams T., Gores G.J. Clinical diagnosis and staging of cholangiocarcinoma. Nat. Rev. Gastroenterol. Hepatol. 2011; 8(9): 512-22.
  2. Miyakawa S., Ishihara S., Horiguchi A., Takada T., Miyazaki M., Nagakawa T. Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan. J. Hepatobiliary Pancreat. Surg. 2009; 16: 1-7.
  3. Tamada K., Ushio J., Sugano K. Endoscopic diagnosis of extrahepatic bile duct carcinoma: Advances and current limitations. World J. Clin. Oncol. 2011 May 10; 2(5): 203-16.
  4. Morana G., Dorigo A. Imaging of cholangiocarcinoma. Cancer Imag. 2011; 11 (Spec. No A): S72-3.
  5. Nathan H., Aloia T.A., Vauthey J.N., Abdalla E.K., Zhu A.X., Schulick R.D. et al. A proposed staging system for intrahepatic cholangiocarcinoma. Ann. Surg. Oncol. 2009; 16: 14-22.
  6. Yamamoto Y., Shimada K., Sakamoto Y., Esaki M., Nara S., Ban D. et al. Clinicopathological characteristics of intrahepatic cholangiocellular carcinoma presenting intrahepatic bile duct growth. J. Surg. Oncol. 2009; 99: 161-5.
  7. Chung Y.J., Choi D.W., Choi S.H., Heo J.S., Kim D.H. Prognostic factors following surgical resection of distal bile duct cancer. J. Korean Surg. Soc. 2013; 85(5): 212-8.
  8. Xu J., Igarashi S., Sasaki M., Matsubara T., Yoneda N., Kozaka K. et al. Intrahepatic cholangiocarcinomas in cirrhosis are hypervascular in comparison with those in normal livers. Liver Int. 2012; 32(7): 1156-64.
  9. Razumilava N., Gores G.J. Classification, diagnosis, and management of cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2013; 11(1): 13-21.
  10. Foley W.D., Quiroz F.A. The role of sonography in imaging of the biliary tract. Ultrasound Quart. 2007; 23(2): 123-35.
  11. Gorycki T., Studniarek M. Bile duct strictures caused by solid masses: MR in differential diagnosis and as a prognostic tool to plan the endoscopic treatment. Gastroenterol. Res. Pract. 2013; 2013: 729279.
  12. Vilgrain V. Staging cholangiocarcinoma by imaging studies. HPB (Oxford). 2008; 10(2): 106-9.
  13. Valero V. 3rd, Cosgrove D., Herman J.M., Pawlik T.M. Management of perihilar cholangiocarcinoma in the era of multimodal therapy. Expert. Rev. Gastroenterol. Hepatol. 2012; 6(4): 481-95.
  14. Akamatsu N., Sugawara Y., Hashimoto D. Surgical strategy for bile duct cancer: Advances and current limitations. World J. Clin. Oncol. 2011; 2(2): 94-107.
  15. Eloubeidi M.A., Chen V.K., Jhala N.C., Eltoum I.E., Jhala D., Chhieng D.C. et al. Endoscopic ultrasound-guided fine needle aspiration biopsy of suspected cholangiocarcinoma. Clin. Gastroenterol. Hepatol. 2004; 2: 209-13.
  16. Brugge W.R. Advances in the endoscopic management of patients with pancreatic and biliary malignancies. South Med. J. 2006; 99: 1358-66.
  17. Levy M.J., Heimbach J.K., Gores G.J. Endoscopic ultrasound staging of cholangiocarcinoma. Curr. Opin. Gastroenterol. 2012; 28(3): 244-52.
  18. Blechacz B., Gores G.J. Cholangiocarcinoma: advances in pathogenesis, diagnosis, and treatment. Hepatology. 2008; 48: 308-21.
  19. Brock K.K. Imaging and image-guided radiation therapy in liver cancer. Semin. Radiat. Oncol. 2011; 21(4): 247-55.
  20. DeWitt J., Misra V.L., Leblanc J.K., McHenry L., Sherman S. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest. Endosc. 2006; 64: 325-33.
  21. Victor D.W., Sherman S., Karakan T., Khashab M.A. Current endoscopic approach to indeterminate biliary strictures. World J. Gastroenterol. 2012; 18 (43): 6197-205.
  22. Meister T., Heinzow H.S., Woestmeyer C., Lenz P., Menzel J., Kucharzik T. et al. Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology. World J. Gastroenterol. 2013; 19(6): 874-81.
  23. Kim H.M., Park J.Y., Kim K.S., Park M.S., Kim M.J., Park Y.N. et al. Intraductal ultrasonography combined with percutaneous transhepatic cholangioscopy for the preoperative evaluation of longitudinal tumor extent in hilar cholangiocarcinoma. J. Gastroenterol. Hepatol. 2010; 25: 286-92.
  24. Watanapa P., Hargrove N.S., Sirivatanauksorn Y. The potential role of intraoperative ultrasonography in the surgical treatment of hilar cholangiocarcinoma. HPB Surg. 1996; 9(2): 93-6.
  25. Aljiffry M., Walsh M.J., Molinari M. Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009. World J. Gastroenterol. 2009; 15 (34): 4240-62.
  26. Zhimin G., Noor H., Jian-Bo Z., Lin W., Jha R.K. Advances in diagnosis and treatment of hilar cholangiocarcinoma - a review. Med. Sci. Monit. 2013; 19: 648-56.
  27. Neumaier C.E., Bertolotto M., Perrone R., Martinoli C., Loria F., Silvestri E. Staging of hilar cholangiocarcinoma with ultrasound. J. Clin. Ultrasound. 1995; 23: 173-8.

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