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仅表现为胆管扩张的局灶性肝内胆管狭窄的临床及影像学特征

Clinical and Imaging Features of a Focal Intrahepatic Biliary Stricture Visualized Only as Duct Dilatation.

作者信息

Kim Byoung Je, Kim Min Seong, Kim Mi Jeong, Yi Jae Hyuck, Paek Jin Hyuk, Lee Hye Won, Park Chan Hee, Lee Gisu, Kang Koo Jeong

出版信息

J Korean Soc Radiol. 2024 Nov;85(6):1157-1168. doi: 10.3348/jksr.2023.0096. Epub 2024 Nov 21.

Abstract

PURPOSE

We assessed the proportion of patients with a focal intrahepatic stricture (FIHS) that was a precursor lesion or malignancy and visualized only as a duct dilatation.

MATERIALS AND METHODS

This retrospective study assessed patients who underwent surgery or biopsy for an FIHS on CT or MRI between January 2010 and March 2022. The number and proportion of non-precursor benign lesions, precursors, and malignancies were calculated. Clinical variables and imaging features were compared between non-premalignant benign and premalignant/malignant FIHSs.

RESULTS

Twenty-eight patients with confirmed histopathological diagnoses were identified, including 15 men (54.0%) and 13 women (46.0%). The median age of all patients at the first imaging diagnosis was 65 ± 9.54 (range, 43-78) years. Of the 28 patients with FIHSs, 9 (32%) were diagnosed with cholangiocarcinoma and 7 (25%) were diagnosed with precursor lesions, which included six intraductal papillary neoplasms of the bile duct and one biliary intraepithelial neoplasm. Accordingly, 16 (57%) patients had malignant or precursor lesions, and 12 (43%) were diagnosed with non-precursor benign lesions. None of the clinical variables and imaging features used for analysis showed a statistically significant difference between the non-premalignant benign and premalignant/malignant FIHS groups ( > 0.05).

CONCLUSION

FIHSs visualized only as duct dilatation can harbor malignant or precursor lesions.

摘要

目的

我们评估了仅表现为胆管扩张的局灶性肝内狭窄(FIHS)患者中作为前驱病变或恶性肿瘤的比例。

材料与方法

这项回顾性研究评估了2010年1月至2022年3月期间因FIHS接受CT或MRI检查后进行手术或活检的患者。计算了非前驱性良性病变、前驱病变和恶性肿瘤的数量及比例。比较了非癌前良性和癌前/恶性FIHS的临床变量和影像学特征。

结果

确定了28例经组织病理学确诊的患者,其中男性15例(54.0%),女性13例(46.0%)。所有患者首次影像学诊断时的中位年龄为65±9.54(范围43 - 78)岁。在28例FIHS患者中,9例(32%)被诊断为胆管癌,7例(25%)被诊断为前驱病变,其中包括6例胆管内乳头状肿瘤和1例胆管上皮内肿瘤。因此,16例(57%)患者有恶性或前驱病变,12例(43%)被诊断为非前驱性良性病变。用于分析的临床变量和影像学特征在非癌前良性和癌前/恶性FIHS组之间均未显示出统计学上的显著差异(>0.05)。

结论

仅表现为胆管扩张的FIHS可能含有恶性或前驱病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b0c/11625844/256d60cffe60/jksr-85-1157-g001.jpg

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