Abstract: Objective The purpose of this study was to summarize the enhanced magnetic resonance imaging (MRI) feature in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC). Methods 120 patients with primary liver cancer (PLC) were encountered in our hospital between December 2019 and July 2023, and there all underwent enhanced MR scan before hepatectomy. The enhancement MR feature included arterial phase reinforcement characteristics, dynamic reinforcement patterns, abnormal blood perfusion, target sign at hepatobiliary phase, lesion signal form, distal bile duct dilation, and lesion capsule. The receiver operating characteristic curve (ROC) was applied to evaluate the differential diagnostic performance of MRI scanning. Results Out of the 120 patients with PLC, the histo-pathological examination diagnosed ICC in 23 cases and HCC in 97 cases; the percentages of edge of lesion enhancement at arterial phase, gradually dynamic enhancement mode, hepatobiliary target and distal bile duct dilatation in ICC lesions were 69.6%,56.5%, 65.2% and 39.1%, all significantly higher than 44.3%, 17.5%,9.3% and 3.1%, while the percentage of lesion envelope was 4.3%, much lower than 45.4%(P＜0.05) in HCC lesions; based on comprehensive features, the MRI diagnosed ICC in 31 cases and HCC in 89 cases, with the sensitivity of 78.3%, the specificity of 86.6%, the positive predicting value of 58.1% and negative predicting value of 94.4%. Conclusion The enhanced MRI scanning could provide the clues for differentiating the ICC and HCC before surgery, which might help the clinicians make an appropriate management plans.

Key words: Hepatoma, Intrahepatic cholangiocarcinoma, Hepatocellular carcinoma, Magnetic resonance imaging, Feature, Diagnosis