Efficiency of CT & MRI in Diagnosis of Cholangiocarcinoma and Its Histopathological Correlation

Cholangiocarcinoma is the most common primary malignancy of the biliary tract. It is first suspected based on the signs of biliary obstruction, abnormal liver function test and either in ultrasonography or CT done for any other purpose or due to patient signs and symptoms. The diagnosis of Cholangiocarcinoma is very challenging despite various diagnostic methods. Apart from histopathological examination, CT, MRI and MRCP plays an integral role in the diagnosis. This study had involved patient’s records including imaging records such as CT plain and enhanced, MRI (T1WI, T2WI and T1+ C, MRCP), histopathological records, and detailed history from patient. The study showed that majority of the patients were of the age group between 47 years and 80 years with mean age 63 years and it was found that there is slight female preponderance which was 60%. Hypertension, diabetes and heart disease are major previously associated disease found. Hilary region was mostly common location of the tumor which was found to be in about 38% of patients. The Contrast enhanced CT was found to be statistically significant in determining the exact enhancement pattern in the diagnosis of Cholangiocarcinoma (P- Value=0.03). MRI pulse sequences Low T1WI and High T2WI signal intensities are frequently associated in the diagnosis of Cholangiocarcinoma (sensitivity 70%) (P- Value < 0.05). Bile ducts are found to be dilated peripheral to the tumor in 70% of the patients. MRCP was found to best in localizing the obstruction in the bile duct and visualization the biliary structures accurately, which aids in the diagnosis of intrahepatic Cholangiocarcinoma. MRI pulse sequences along with MRCP increases the sensitivity in the diagnosis of Cholangiocarcinoma (P- Value <0.005).