H/O Jaundice.
There is evidence of an intermediate signal intensity mass lesion on the T1W images(hypointense on the T2W images) at the junction of the right and left hepatic ducts. There is dilatation of the intrahepatic biliary ducts upto the level of the confluence of the right and left hepatic ducts. The common hepatic duct(CHD) is not well identified. The visualized common bile duct(CBD) is not dilated. The focal hypointensities on the T2W images within the right hepatic biliary ducts most likely represent calculi.
Cholangiocarcinoma is a primary neoplastic process(malignant) of the bile ducts. Patients commonly present with weight loss and jaundice. This condition may be associated with sclerosing cholangitis, liver fluke infestation, choledochal cyst, exposure to aniline dyes and ulcerative colitis.
This lesion most commonly occurs at the confluence of the right and left
hepatic ducts(also called Klatskin"s tumours). They may also involve the CHD or CBD.
These are classified as central tumours. Occasionally one finds involvement of the
peripheral biliary ducts (peripheral tumours). The histopathology usually reveals an
adenocarcinoma.
On MRI: |
On MR these lesions are usually hypointense on the T2W images and of intermediate signal intensity on the T1W images. These lesions show moderate enhancement on gadolinium enhanced studies (especially with fat suppresion). MRCP shows ductal dilatation. They also allow us to delineate the proximal extent of this lesion which is critical for further management.
An excellent site on MRCP may be accessed at: