Thématique :
- Carcinome hépatocellulaire (CHC)
Originalité :
Solidité :
Très solide
Doit faire évoluer notre pratique :
Pas encore
Nom du veilleur :
Professeur Sylvain MANFREDI
Coup de coeur :
Digestive and Liver Disease
  2018 Apr;50(4):401-407.  
  doi: 10.1016/j.dld.2017.11.003.  
  Contrast enhanced ultrasound in mixed hepatocellular cholangiocarcinoma: Case series and review of the literature  
  Dong Y, Teufel A, Trojan J, Berzigotti A, Cui XW, Dietrich CF  



Mixed hepatocellular cholangiocarcinoma is a rare form of primary liver cancer.


The aim of this study is to report the results of the use of contrast enhanced ultrasound in a series of patients with confirmed mixed hepatocellular cholangiocarcinoma and to provide an updated literature review.


Between January 2012 and October 2016, 25 Asian patients with confirmed mixed hepatocellular cholangiocarcinoma were included in this bicentric retrospective analysis. Clinical data as well recorded images of a standardized conventional B-mode ultrasound and contrast-enhanced ultrasound examination were interpreted by two blinded, independent, experienced radiologists in consensus.


All mixed hepatocellular cholangiocarcinoma lesions were heteroechoic on B-mode ultrasound, with ill-defined margins and irregular shapes. Arterial phase hyperenhancement was present in all 25 patients. Late-phase washout and hypoenhancement was present in 24/25 (96%) patients. However, rim-enhancement and early wash-out (which are common in cholangiocellular carcinoma) were found in over 60% of the cases.


Contrast-enhanced ultrasound demonstrated findings not typical for HCC in a large proportion of patients with confirmed mixed hepatocellular cholangiocarcinoma. Therefore, histological confirmation is crucial, especially in lesions with atypical findings.


Question posée
Est-ce que l’échographie de contraste peut différencier les CHC des hépato-cholangiocarcinomes ?
Question posée
Malgré des différences de comportements vasculaires en échographie de contraste, l’écho de contraste ne permet pas de se passer de la biopsie.