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胆管腺瘤的影像学特征:病例系列及文献复习。

Imaging features of bile duct adenoma: case series and review of literature.

机构信息

Department of Radiology Mayo Clinic, Rochester, Minnesota, USA.

Department of Laboratory Medicine and Pathology Mayo Clinic, Rochester, Minnesota, USA.

出版信息

Diagn Interv Radiol. 2018 Sep;24(5):249-254. doi: 10.5152/dir.2018.18036.

Abstract

PURPOSE

We aimed to evaluate the imaging features of bile duct adenoma (BDA) on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI).

METHODS

Retrospective search in our institution database was performed for histologically confirmed BDA. Their imaging studies before histologic confirmation were reviewed. The search identified seven adults (mean age, 52.9 years) with histologically proven single BDA each. US (n=3), CT (n=5), and MRI (n=3) were performed before histologic confirmation. Additionally, a systematic English literature review for BDA and reported imaging findings since 2000 was also conducted using the following search criteria "bile duct adenoma, peribiliary hamartoma, biliary adenoma, CT, ultrasound, MRI" (date range: 01/01/2000 through 08/31/2016). The imaging findings of those cases reported were summarized and compared with our series.

RESULTS

All seven individual nodules were well circumscribed. Five lesions were located in the right hepatic lobe and two in the left hepatic lobe. On US, lesions appeared hypoechoic (n=2) and hyperechoic (n=1). BDA was hypodense on unenhanced CT images (n=1). On MRI, BDA were hypointense on T1 (n=3), hyperintense on T2 (n=3), and hyperintense on diffusion-weighted images (n=2). On contrast-enhanced CT and MRI, BDAs showed arterial phase hyperenhancement that persisted on portal venous/delayed phase images.

CONCLUSION

BDA demonstrates characteristic arterial phase hyperenhancement that persisted into the portal venous and delayed phases on CT and MRI, which may be useful in differentiating from other hepatic lesions.

摘要

目的

我们旨在评估超声(US)、计算机断层扫描(CT)和磁共振成像(MRI)下胆管腺瘤(BDA)的影像学特征。

方法

我们对经组织学证实的 BDA 患者进行了回顾性检索,并对其组织学确诊前的影像学研究进行了回顾。共发现 7 名成人(平均年龄 52.9 岁),每个患者均为单个组织学证实的 BDA。在组织学确诊前分别进行了 US(n=3)、CT(n=5)和 MRI(n=3)检查。此外,还使用了以下搜索标准“胆管腺瘤、周围胆管错构瘤、胆管腺瘤、CT、超声、MRI”,对自 2000 年以来的 BDA 及报告的影像学发现进行了系统的英文文献综述(日期范围:2000 年 1 月 1 日至 2016 年 8 月 31 日)。对报告的这些病例的影像学表现进行了总结,并与我们的系列进行了比较。

结果

所有 7 个结节均边界清楚。5 个病变位于右肝叶,2 个位于左肝叶。US 上,病变呈低回声(n=2)和高回声(n=1)。BDA 在未增强 CT 图像上呈低密影(n=1)。MRI 上,BDA 在 T1 上呈低信号(n=3),T2 上呈高信号(n=3),扩散加权图像上呈高信号(n=2)。在 CT 和 MRI 增强扫描上,BDA 显示动脉期强化,门静脉期/延迟期持续强化。

结论

BDA 在 CT 和 MRI 上显示出特征性的动脉期强化,门静脉期/延迟期持续强化,这可能有助于与其他肝病变相鉴别。

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