当前位置： SCI文献检索 > EUROPEAN RADIOLOGY期刊下所有文献 > CT imaging comparison between intraductal papillary neoplasms of the bile duct and papillary cholangiocarcinomas.

CT imaging comparison between intraductal papillary neoplasms of the bile duct and papillary cholangiocarcinomas.

Abstract：

OBJECTIVES:To identify imaging features that assist in discriminating intraductal papillary neoplasms of the bile duct (IPNBs) from papillary cholangiocarcinomas (PCCs). METHODS:This study was approved by the institutional review board. Using the recently proposed histological diagnostic criteria for biliary papillary neoplasms, IPNBs and PCCs were selected from 537 biliary neoplasms consecutively resected in a 12.5-year period. Clinical and imaging features were compared between the two groups. RESULTS:The histology review identified 19 IPNBs and 48 PCCs, representing an estimated prevalence of IPNBs among biliary neoplasms of 4%. Approximately one half of IPNBs were incidentally found on imaging conducted for other purposes. In terms of tumor location, 15/19 IPNBs (79%) developed in intrahepatic bile ducts, and 41/48 PCCs (85%) in the distal bile duct. Cystic appearance was highly suggestive for IPNBs (p < 0.001). Using these two parameters, 78% of papillary bile duct neoplasms could be classified into IPNBs or PCCs. Other imaging findings favoring IPNBs included frond-like mural nodule, downstream bile duct dilatation, and the lack of abnormal enhancement in the adjacent bile duct. Interestingly, two patients with non-invasive or microinvasive IPNB had undergone abdominal imaging studies > 3 years before, and a retrospective review of the previous images identified small nodular or cystic lesions, suggesting a less progressive nature of IPNBs than currently thought. CONCLUSIONS:Imaging findings useful for discriminating IPNBs from PCCs appear to be tumor location, shape of tumor, appearance of mural nodules, duct dilatation at unaffected duct, and abnormal enhancement of the adjacent bile duct. KEY POINTS:• Intrahepatic location and cystic dilatation of the affected bile duct are the strong discriminators between IPNBs and PCCs. • The shape of the mural nodule and appearance of the neighboring bile duct are helpful for distinguishing IPNBs and PCCs. • The less aggressive behavior of IPNBs compared with PCCs may facilitate less invasive management in patients with IPNB.

journal_name

Eur Radiol

journal_title

European radiology

authors

Komori T,Inoue D,Zen Y,Yoneda N,Kitao A,Kozaka K,Yokka A,Toshima F,Matsubara T,Kobayashi S,Gabata T

doi

10.1007/s00330-018-5841-0

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

3132-3140

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-018-5841-0

journal_volume

pub_type

杂志文章

在线工具

CT imaging comparison between intraductal papillary neoplasms of the bile duct and papillary cholangiocarcinomas.