Lewis Vanessa A, Adam Sharon Z, Nikolaidis Paul, Wood Cecil, Wu James G, Yaghmai Vahid, Miller Frank H
Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair, Suite 800, Chicago, IL, 60611, USA.
Abdom Imaging. 2015 Aug;40(6):1567-80. doi: 10.1007/s00261-015-0381-4.
Choledochal cysts are rare cystic dilatations of the intrahepatic and/or extrahepatic biliary tree, which may be mistaken for other cystic lesions if their characteristic features are not recognized. The etiology is unknown, and likely multifactorial, and it is uncertain whether they are congenital or acquired. Multiple imaging modalities can be used to diagnose choledochal cysts, including ultrasound, computed tomography, magnetic resonance (MR) cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography, and percutaneous transhepatic cholangiography. MRCP has replaced the more invasive techniques as the gold standard of diagnosis. In addition, MRCP is helpful in detecting an abnormal pancreaticobiliary junction, which is seen in the majority of choledochal cysts. Reaching a correct diagnosis is essential, given the associated risk of complications, including cholangitis, biliary strictures, stones, and malignancy, and accurately assessing the location and length of involvement is important for surgical planning. This review aims to familiarize radiologists with the different types of choledochal cysts and their imaging features according to the Todani classification.
胆总管囊肿是肝内和/或肝外胆管树的罕见囊性扩张，如果不认识其特征性表现，可能会被误诊为其他囊性病变。其病因不明，可能是多因素的，尚不确定它们是先天性还是后天性的。多种成像方式可用于诊断胆总管囊肿，包括超声、计算机断层扫描、磁共振（MR）胰胆管造影（MRCP）、内镜逆行胰胆管造影和经皮经肝胆管造影。MRCP已取代侵入性更强的技术成为诊断的金标准。此外，MRCP有助于检测异常的胰胆管连接，这在大多数胆总管囊肿中都可见。鉴于存在胆管炎、胆管狭窄、结石和恶性肿瘤等相关并发症风险，做出正确诊断至关重要，准确评估受累部位和长度对于手术规划也很重要。本综述旨在使放射科医生熟悉根据Todani分类的不同类型胆总管囊肿及其成像特征。
