Sundaram Karthik M, Morgan Matthew A, Itani Malak, Thompson William
Department of Radiology, University of Pennsylvania Health System, 1 Silverstein, 3400 Spruce Street, Philadelphia, PA, USA.
Mallinkckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, USA.
Abdom Radiol (NY). 2023 Jan;48(1):106-126. doi: 10.1007/s00261-022-03440-5. Epub 2022 Feb 24.
Pathologies of the biliary tree include a wide-spectrum of benign and malignant processes. The differential for benign disease includes congenital and acquired disease with variable prognosis and management pathways. Given the ability to mimic malignancy, benign processes are difficult to diagnose by imaging. Direct cholangiography techniques with tissue sampling are the gold standards for the diagnosis of benign and malignant biliary pathologies. Non-invasive imaging with ultrasound offers a first-line diagnostic tool while MRI/MRCP offers higher specificity for identifying underlying pathology and distinguishing from malignant disease. In this review, we focus on the imaging appearance of dilatation, cystic anomalies obstruction, inflammation, ischemia, strictures, pneumobilia, and hemobilia to help construct a differential for benign processes.
胆道疾病包括一系列广泛的良性和恶性病变。良性疾病的鉴别诊断包括先天性和后天性疾病，其预后和治疗途径各不相同。鉴于良性病变有模仿恶性肿瘤的可能，通过影像学检查很难对其进行诊断。直接胆管造影技术及组织采样是诊断良性和恶性胆道疾病的金标准。超声无创成像提供了一线诊断工具，而MRI/MRCP在识别潜在病变及与恶性疾病鉴别方面具有更高的特异性。在本综述中，我们重点关注扩张、囊性异常、梗阻、炎症、缺血、狭窄、气肿性胆囊炎和胆道出血的影像学表现，以帮助构建良性病变的鉴别诊断。
