Huang Mengyue, Huang Mengna, Gao Xuemei, Zhang Yong, Cheng Jingliang, Zhu Jinxia, Li Caixia, Liu Jingjing
Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Magnetic Resonance Imaging (MRI) Collaboration, Siemens Healthcare Ltd., Beijing, China.
Front Oncol. 2023 Aug 16;13:1180186. doi: 10.3389/fonc.2023.1180186. eCollection 2023.
To evaluate the magnetic resonance imaging (MRI) features of bile duct adenoma.
The data of 28 patients [with 32 pathologically confirmed bile duct adenomas, including 15 with malignant change (malignant group) and 17 without malignant change (benign adenoma group)] were retrospectively reviewed. Abdominal MRI was performed for all patients; in addition, dynamic enhanced MRI was performed for 18 lesions. The MRI features, including lesion location, maximum size, morphology, signal characteristics, enhancement type, and appearance of the bile duct, were assessed by two abdominal radiologists. Apparent diffusion coefficient (ADC) values were measured and compared.
Of the 32 bile duct adenomas, 22 (68.75%) involved the common bile duct (CBD). While 14/32 (43.75%) lesions presented as focal eccentric-type masses, 9/32 (28.13%) presented as plaque-like masses, 4/32 (12.50%) as bile duct casting masses, and 5/32 (15.62%) as infiltrative masses. A frond-like superficial appearance was seen in 8/32 (25%) lesions. Infiltrative masses were significantly more common in the malignant group than in the benign adenoma group ( = 0.015). While 23/32 (71.88%) lesions were isointense on T1-weighted imaging (T1WI), 24/32 (75%) were hyperintense on T2-weighted imaging (T2WI). Bile duct dilatation was present upstream of the lesion in all cases. Bile duct dilatation at the lesion was seen in 24/32 (75%) cases and downstream of the lesion in 6/32 (18.75%) cases. Of the 18 lesions that underwent dynamic enhanced MRI, 14 (77.78%) showed moderate enhancement and 13 (72.22%) showed persistent enhancement. On diffusion-weighted imaging (DWI), 27/32 (84.37%) lesions showed hyperintensity. Mean ADC value was comparable between the malignant group and the benign adenoma group ( 0.156).
Bile duct adenoma primarily presents as intraductal growth in the CBD, usually with bile duct dilatation at the lesion site or upstream to it. Most lesions are isointense on T1WI, are hyperintense on T2WI and DWI, and show moderate enhancement. A superficial frond-like appearance of the lesion and bile duct dilatation at the lesion or downstream to it might be characteristics of bile duct adenoma. An infiltrative appearance might indicate malignant transformation.
评估胆管腺瘤的磁共振成像（MRI）特征。
回顾性分析28例患者（共32个经病理证实的胆管腺瘤，其中15例发生恶变，为恶变组；17例未发生恶变，为良性腺瘤组）的数据。对所有患者均进行腹部MRI检查；另外，对18个病灶进行了动态增强MRI检查。由两名腹部放射科医生评估MRI特征，包括病灶位置、最大径、形态、信号特征、强化类型及胆管表现。测量并比较表观扩散系数（ADC）值。
32个胆管腺瘤中，22个（68.75%）累及胆总管（CBD）。14/32（43.75%）个病灶表现为局灶偏心型肿块，9/32（28.13%）个表现为斑块状肿块，4/32（12.50%）个表现为胆管铸型肿块，5/32（15.62%）个表现为浸润性肿块。8/32（25%）个病灶可见叶状浅表外观。浸润性肿块在恶变组中显著多于良性腺瘤组（P = 0.015）。23/32（71.88%）个病灶在T1加权成像（T1WI）上呈等信号，24/32（75%）个在T2加权成像（T2WI）上呈高信号。所有病例中，病灶上游均可见胆管扩张。病灶处胆管扩张见于24/32（75%）个病例，病灶下游见于6/32（18.75%）个病例。在18个接受动态增强MRI检查的病灶中，14个（77.78%）呈中度强化，13个（72.°22%）呈持续性强化。在扩散加权成像（DWI）上，27/32（84.37%）个病灶呈高信号。恶变组与良性腺瘤组的平均ADC值相当（P = 0.156）。
胆管腺瘤主要表现为胆总管内生长，通常在病灶部位或其上游伴有胆管扩张。大多数病灶在T1WI上呈等信号，在T2WI和DWI上呈高信号，并表现为中度强化。病灶的浅表叶状外观以及病灶处或其下游的胆管扩张可能是胆管腺瘤的特征。浸润性外观可能提示恶变。
