Radiological diagnosis and staging of hilar cholangiocarcinoma

Figure 4 Periductal cholangiocarcinoma multidetector computed tomography and magnetic resonance cholangiopancreatography. A: Multidetector computed tomography in the portal phase shows periductal cholangiocarcinoma (arrow) producing complete biliary obstruction and atrophy of the right liver; B: Coronal reconstruction shows to a better advantage the scirrhous infiltrating cholangiocarcinoma slightly hyperenhancing (arrow) and the dilated bile ducts upstream; C: Coronal thick-slab (echo spacing 8.3 ms, effective echo time 1000 ms, image matrix 512 x 512, FOV 350 mm) MRCP T2-W sequence in the same patient shows marked dilatation of intrahepatic bile ducts and a signal void (arrow) at the level of the hepatic convergence and common hepatic duct consistent with malignant obstruction by cholangiocarcinoma; D: Matrix (272 x 512, FOV 385 mm) T2-W sequence shows marked dilatation of the intrahepatic ducts and a narrow stenosis at the hepatic bifurcation (arrow).