内镜逆行胰胆管造影时的胆总管末端假性肿瘤。
Pseudotumor of the distal common bile duct at endoscopic retrograde cholangiopancreatography.
机构信息
Department of Radiology, University of California San Francisco, San Francisco, CA 94143-0628, USA.
出版信息
Clin Imaging. 2011 Jul-Aug;35(4):279-83. doi: 10.1016/j.clinimag.2010.07.004.
BACKGROUND
Prior studies have described a pseudocalculus appearance in the distal common bile duct as a normal variant at cholangiography. The objective of this study was to describe the occurrence of pseudotumor in the distal common bile duct at endoscopic retrograde cholangiopancreatography (ERCP).
METHODS
Nine patients who underwent ERCP between May 2004 and July 2008 were identified as having a transient eccentric mural-based filling defect in the distal common bile duct. A single reader systematically reviewed all studies and recorded the imaging findings.
RESULTS
The mean diameter of the filling defect was 9 mm (range, 5 to 11). Eight patients had resolution of the filling defect during the same ERCP or on a subsequent ERCP, and in two of these patients the inferior border of the filling defect was not well visualized. The other patient underwent surgical resection of a presumed tumor with no evidence of malignancy on surgical pathology.
CONCLUSION
An eccentric mural-based filling defect in the distal common bile duct can be artifactual in nature and may reflect transient contraction of the sphincter of Oddi. Recognition of this pseudotumor may help avoid unnecessary surgery.
背景
先前的研究描述了胆总管远端假性结石外观是胆系造影的一种正常变异。本研究的目的是描述内镜逆行胰胆管造影（ERCP）时胆总管远端假性肿瘤的发生情况。
方法
2004 年 5 月至 2008 年 7 月间进行 ERCP 的 9 例患者被确定为胆总管远端存在短暂偏心性基于壁的充盈缺损。一名读者系统地回顾了所有的研究并记录了影像学发现。
结果
充盈缺损的平均直径为 9 毫米（范围，5 至 11）。8 例患者在同一次 ERCP 或随后的 ERCP 中充盈缺损消失，其中 2 例患者充盈缺损的下边界显示不佳。另一位患者接受了疑似肿瘤的手术切除，但手术病理无恶性证据。
结论
胆总管远端偏心性基于壁的充盈缺损可能是人为的，可能反映Oddi 括约肌的短暂收缩。认识到这种假性肿瘤可以避免不必要的手术。
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