胆管内乳头状肿瘤的形态学分类。
Morphological classification of intraductal papillary neoplasm of the bile duct.
机构信息
Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, China.
Department of Radiology, Jinhua Municipal Central Hospital, 365 Renmin Dong Road, Jinhua, 321000, China.
出版信息
Eur Radiol. 2018 Apr;28(4):1568-1578. doi: 10.1007/s00330-017-5123-2. Epub 2017 Nov 14.
OBJECTIVES
To investigate the morphological classification of intraductal papillary neoplasm of the bile duct (IPNB), as well as morphological differences between IPNB without mucin secretion (IPNB-NM) and IPNB with mucin secretion (IPMN-B).
METHODS
Eighty-one patients with IPNB were retrospectively analysed. Imaging examinations included computed tomography (CT), magnetic resonance imaging (MRI), gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI and positron emission tomography-computed tomography (PET-CT). According to the morphology of tumours and extent of bile duct dilations, IPNB was classified into seven types: I, upstream-ductectatic type; II, typical type; III, superficial-spreading type; IV, no-mass-forming type; V, intrahepatic-cystic type; VI, extrahepatic-cystic type; and VII, infiltrating type.
RESULTS
Thirteen IPNB-NM patients comprised type I (11 cases), type II (1 case) and type VII (1 case); 68 IPMN-B patients comprised type I (2 cases), type II (30 cases), type III (6 cases), type IV (11 cases), type V (13 cases), type VI (2 cases) and type VII (4 cases). Bile duct dilations were more severe in IPMN-B than in IPNB-NM. PET-CT and Gd-EOB-DTPA-enhanced MRI clearly demonstrated the extension of infiltrating IPNB.
CONCLUSIONS
IPNB can be classified into seven morphological types. IPNB-NM and IPMN-B have different morphological features.
KEY POINTS
• IPNB can be classified into seven morphological types. • IPNB-NM and IPMN-B have different morphological features. • Enhanced CT and MRI can display different types of IPNB. • Morphological classification of IPNB facilitates management of the disease.
目的
探讨胆管内乳头状肿瘤（IPNB）的形态学分类，以及无黏液分泌的 IPNB（IPNB-NM）和有黏液分泌的 IPNB（IPMN-B）之间的形态学差异。
方法
回顾性分析 81 例 IPNB 患者的资料。影像学检查包括计算机断层扫描（CT）、磁共振成像（MRI）、钆乙氧基苯甲基二乙三胺五乙酸（Gd-EOB-DTPA）增强 MRI 和正电子发射断层扫描-CT（PET-CT）。根据肿瘤的形态和胆管扩张程度，将 IPNB 分为 7 型：I 型为上游胆管扩张型；II 型为典型型；III 型为浅表扩散型；IV 型为无肿块形成型；V 型为肝内囊性型；VI 型为肝外囊性型；VII 型为浸润型。
结果
13 例 IPNB-NM 患者中，I 型 11 例，II 型 1 例，VII 型 1 例；68 例 IPMN-B 患者中，I 型 2 例，II 型 30 例，III 型 6 例，IV 型 11 例，V 型 13 例，VI 型 2 例，VII 型 4 例。IPMN-B 的胆管扩张较 IPNB-NM 更严重。PET-CT 和 Gd-EOB-DTPA 增强 MRI 可清晰显示浸润性 IPNB 的延伸范围。
结论
IPNB 可分为 7 种形态学类型。IPNB-NM 和 IPMN-B 具有不同的形态学特征。
重点
IPNB 可分为 7 种形态学类型。
IPNB-NM 和 IPMN-B 具有不同的形态学特征。
增强 CT 和 MRI 可显示不同类型的 IPNB。
IPNB 的形态学分类有助于疾病的管理。
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