Imaging features and management of focal liver lesions

Figure 11  Intrahepatic cholangiocarcinoma. A: Ultrasound shows a heterogeneous slightly hyperechoic lesion (arrow); B: Axial non-contrast computed tomography (CT) image demonstrates an ill-defined hypodense lesion (arrow) that causes capsular retraction (white arrowheads); C: Axial contrast-enhanced CT image in the arterial phase shows peripheral enhancement (targetoid appearance) of the lesion (arrow); D: Axial contrast-enhanced CT image in the portal venous phase shows progressive enhancement (black arrowheads) of the lesion (arrow); E: Axial contrast-enhanced CT image in the delayed phase shows further progressive enhancement (black arrowheads) of the lesion (arrow); F: Axial T2 weighted magnetic resonance imaging (MRI) shows a T2 peripherally hyperintense, centrally hypointense ill-defined, heterogeneous lesion (arrow) with capsular retraction (white arrowheads); G: Axial T1 weighted MRI shows a T1 hypointense ill-defined, heterogeneous lesion (arrow) with capsular retraction (white arrowheads); H: Axial T1 weighted MRI with an extracellular gadolinium-based contrast agent in the portal venous phase shows a T1 hypointense lesion (arrow) with progressive enhancement (black arrowheads); I: Axial T1 weighted MR image in the delayed phase shows a hypointense lesion (arrow) with further progressive enhancement (black arrowheads).