适当预先鉴别iCCA亚型对于个性化治疗至关重要，因此本研究旨在研究MR成像特征在术前区分iCCA亚型中的作用。按照最新的第五版WHO分类，回顾性纳入了93例具有肿块性肝内胆管癌（iCCA，63例小管型和30例大管型）患者（平均年龄，男性与女性：60.66±10.53 vs. 61.88±12.82，男性50人）。经过单因素和多因素逻辑回归分析，确定了区分大管型iCCA和小管型iCCA的显著成像特征，并生成了基于回归的预测模型。此外，获得了单一显著成像特征和预测模型的诊断绩效指标，并随后呈现了相应的受试者操作特征曲线（ROC曲线）。 单因素分析表明，静脉中肿瘤、动脉期低增强、肝内胆管扩张、缺乏靶样限制和T2缺乏靶样外观是大管型iCCA的预测因素。动脉期低增强、肝内胆管扩张和缺乏靶样限制在多因素分析中是大管型iCCA的独立预测因素。回归模型在iCCA亚分类中已经取得了最佳的术前预测表现。基于回归的预测模型的ROC曲线下面积高达0.91（95％CI：0.85，0.98），明显高于每个单一显著成像特征。 动脉期低增强、肝内胆管扩张和缺乏靶样限制可以被认为是大管型iCCA的可靠MR成像指标。 MR成像特征可以促进满意的预测绩效下的无创预测iCCA亚型。©2023年。作者。

Appropriate preoperative identification of iCCA subtype is essential for personalized management, so the aim of this study is to investigate the role of MR imaging features in preoperatively differentiating the iCCA subtype.Ninety-three patients with mass-forming intrahepatic cholangiocarcinoma (iCCA, 63 small duct type and 30 large duct type) were retrospectively enrolled according to the latest 5th WHO classification (mean age, males vs. females: 60.66 ± 10.53 vs. 61.88 ± 12.82, 50 men). Significant imaging features for differentiating large duct iCCA and small duct iCCA were identified using univariate and multivariate logistic regression analyses, and a regression-based predictive model was then generated. Furthermore, diagnostic performance parameters of single significant imaging features and the predictive model were obtained, and corresponding receiver operating characteristic (ROC) curves were subsequently presented.The univariate analysis showed that tumor in vein, arterial phase hypoenhancement, intrahepatic duct dilatation, lack of targetoid restriction and lack of targetoid appearance in T2 were predictors of large duct type iCCA. Arterial phase hypoenhancement, intrahepatic duct dilatation and lack of targetoid restriction were independent predictors for large duct type iCCA in multivariate analysis. The regression-based predictive model has achieved the best preoperative prediction performance in iCCA subcategorization so far. The area under the ROC curve of the regression-based predictive model was up to 0.91 (95% CI: 0.85, 0.98), and it was significantly higher than every single significant imaging feature.Arterial phase hypoenhancement, intrahepatic duct dilatation and lack of targetoid restriction could be considered reliable MR imaging indicators of large duct type iCCA. MR imaging features can facilitate noninvasive prediction of iCCA subtype with satisfactory predictive performance.© 2023. The Author(s).