Figure 2. 62-year-old woman with a history of stage IV ICC. The patient’s initial symptoms were abdominal pain and malaise.
(a) Contrast-enhanced T1-weighted gradient-echo sequence in the portal-venous phase shows multiple lesions in all liver lobes, on the shown axial slice, two lesions in segment 2 (asterisks, *) and one lesion in segment 4a/8 (arrowheads) are visible. (b) On DSA acquired with the catheter tip in the left hepatic artery, these lesions were not clearly visible and only other already known lesions in segments 3 & 4b were vaguely depicted (arrowheads). (c) On early-phase CBCT, the fibrotic core of the lesions in segment 2 (asterisk) is poorly demarcated, the enhancing rims are depicted only partially (arrowheads). The lesion in segment 4a/8 is not visible. (d) On delayed-phase CBCT, the lesions in segment 2 are completely depicted (asterisks) as enhancing rims surrounding a hypo-intense center compared to the healthy liver parenchyma, whereas the lesion in segment 4a/8 is only partially depicted due to the dual blood supply from the right and left hepatic artery (arrowheads).
