Kelly I M, Lees W R, Russell R C
Department of Diagnostic Imaging, Middlesex Hospital, London.
Clin Radiol. 1993 Apr;47(4):251-4. doi: 10.1016/s0009-9260(05)81132-8.
Two patients with obstructive biliary symptoms were shown to have dilated bile ducts on ultrasound. Within the lumen of both distal common ducts (CBD) large low echogenicity polypoid masses without acoustic shadowing were seen. MRI in one patient showed a polypoid filling defect in the lower CBD corresponding to the ultrasound appearance. Instrumentation at the lower end of both CBDs caused disintegration of the polypoid configuration resulting in the more typical layered appearance of biliary sludge. Sludge in the gall-bladder as seen on ultrasound is rarely known to cause a pseudotumour appearance. It has not previously been reported as occurring in the CBD and awareness of the tumefactive appearance of biliary sludge in the common duct is important and should help avoid possible misinterpretation.
两名有梗阻性胆道症状的患者经超声检查显示胆管扩张。在两条胆总管远端管腔内均可见到无声影的低回声息肉样大肿块。其中一名患者的MRI显示胆总管下段有一个息肉样充盈缺损，与超声表现相符。对两条胆总管下端进行器械操作导致息肉样结构解体，形成了更典型的胆泥分层外观。超声所见胆囊内的胆泥很少会引起假肿瘤样表现。此前尚未有胆总管内出现胆泥的报道，认识到胆总管内胆泥的肿块样表现很重要，有助于避免可能的误诊。
