Abstract: Objective The aim of this study was to analyze the CT enhancement scan imaging feature of cholangiocellular carcinoma (CCC) in a series of patients with intrahepatic space-occupying lesions (ihSOL). Methods A total of consecutive 376 patients with ihSOL revealed by ultrasonography were encountered in our hospital between March 2020 and March 2023, and all underwent CT plain scan and multi-phase enhancement scan. The diagnosis was made based on pathology from tissues obtained by laparoscopic radical operation or fine needle aspiration biopsy. The diagnostic performance of multi-phase CT enhancement scan was analyzed by Kappa coefficient test. Results Out of the 376 patients with ihSOL, the pathological examination showed that there were 149 cases with benign lesions and 227 cases with malignant lesions, including CCC in 18 cases and hepatocellular carcinoma (HCC) in 209 cases; the multi-phase CT enhancement scan diagnosed benign lesions in 151 cases and malignant lesions in 225 cases, including ICC in 21 cases, all single lesion, 61.9% of them located in left lobe, 57.1% of them shaped in mass, with the diameters of(6.7±1.8)cm; the edges of mass tumors mildly intensified at arterial phase and portal phase, while vigorously intensified at delayed phase; the intra-lumen tumors adjacent to porta hepatis mildly intensified at arterial phase, gradually further intensified at portal and delayed phases; intrahepatic infiltrating tumors at bile duct walls mildly intensified, gradually persistently intensified at portal and delayed phases; out of the 225 patients with malignant lesions [intrahepatic cholangiocellular carcinoma (ICC) in 21 and HCC in 204 cases] demonstrated by CT scan, the pathological examination diagnosed ICC in 17 cases and HCC in 208 cases (Kappa=0.766), with the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 94.1%, 97.6%, 97.3%, 76.2% and 99.5%. Conclusion The feature of ICC by multi-phase CT enhancement scan is characteristic, which might help the clinicians make a plan for management.

Key words: Cholangiocellular carcinoma, CT plain and enhancement scan, Feature, Diagnosis