囊肿型胆管乳头状肿瘤患者CT及MRI影像学特征观察

肝脏 ›› 2021, Vol. 26 ›› Issue (7): 792-794.

囊肿型胆管乳头状肿瘤患者CT及MRI影像学特征观察

沈进东, 耿承军, 殷慧康, 郎蔚渭

214000 无锡解放军第904联勤保障部队医学影像科

收稿日期:2021-02-22 出版日期:2021-07-31 发布日期:2021-09-02
通讯作者: 耿承军,Email:hfgcj@yeah.net

CT and MRI features of cystic papillary tumor of bile duct

SHEN Jin-dong, GENG Cheng-jun, YIN Hui-kang, LANG Wei-wei

Department of Medical Imaging,The 904th joint logistics support force of PLA,Wuxi 214000, China

Received:2021-02-22 Online:2021-07-31 Published:2021-09-02
Contact: GENG Cheng-jun,Email:hfgcj@yeah.net

摘要/Abstract

摘要： 目的观察囊肿型胆管乳头状肿瘤(IPNB)患者CT及MRI影像学特征。方法选择2017年12月至2019年12月解放军第904联勤保障部队医院经术后病理学检测为囊肿型IPNB的患者90例,经术后病理学检测为肝脏黏液性囊性肿瘤(MCN)的患者90例,两组术前均行CT及MRI影像学检查,分析两组临床资料及影像学特征。依据病理结果将IPNB组分为侵袭性病变(51例)与非侵袭性病变(39例),分析其影像学特征。结果 IPNB组病灶内部附壁结节、胆管交通、胆管扩张例数分别为57例(63.33%)、46例(51.11%)、90例(100.00%),高于MCN组的16例(17.78%)、0、16例(17.78%),差异有统计学意义(P<0.05)。IPNB组中侵袭性病变的病灶直径为(7.49±0.68)cm,高于非侵袭性病变组的(5.53±0.46)cm,差异有统计学意义(P<0.05)。结论囊肿型IPNB的CT及MRI影像学表现为病灶内部附壁结节、胆管交通、胆管扩张其病灶直径越大,为侵袭性病变的可能性越高。

关键词: 囊肿型, 胆管乳头状肿瘤, CT, MRI, 影像学特征

Abstract: Objective To observe the CT and MRI features of cystic intraductal papillary neoplasms of the bile duct (IPNB). Methods 90 patients with cystic IPNB were retrospectively analyzed, another 90 patients with mucinous cystic tumor (MCN) were selected as MCN group. The clinical data and imaging features of the two groups were analyzed. At the same time, IPNB group was divided into invasive lesions (51 cases) and non-invasive lesions (39 cases) according to the pathological results. Results The proportion of mural nodules, bile duct communication and bile duct dilatation in IPNB group (63.33%, 51.11%, 100.00%) was significantly higher than that in MCN group (17.78%, 0.00%, 17.78%) (P<0.05). In IPNB group, the diameter of invasive lesions [(7.49±0.68) cm] was significantly higher than that of non-invasive lesions [(5.53±0.46) cm] (P<0.05). Conclusion In CT and MRI imaging features, mural nodules, bile duct communication and bile duct dilatation can be used as the basis for clinical diagnosis and differential diagnosis of cystic IPNB. In addition, the larger the diameter of cystic IPNB, the higher the possibility of invasive lesions.

Key words: Cystic type, Intraductal papillary neoplasms of the bile duct, CT, MRI, Imaging features

沈进东, 耿承军, 殷慧康, 郎蔚渭. 囊肿型胆管乳头状肿瘤患者CT及MRI影像学特征观察[J]. 肝脏, 2021, 26(7): 792-794.

SHEN Jin-dong, GENG Cheng-jun, YIN Hui-kang, LANG Wei-wei. CT and MRI features of cystic papillary tumor of bile duct[J]. Chinese Hepatolgy, 2021, 26(7): 792-794.

参考文献

[1] 王士东, 王小玮, 刘国红,等. 胆管内乳头状肿瘤的研究现状. 临床肝胆病杂志, 2020, 36:238-242.
[2] Aoki Y, Mizuma M, Hata T, et al .Intraductal papillary neoplasms of the bile duct consist of two distinct types specifically associated with clinicopathological features and molecular phenotypes. J Pathol. 2020, 251:38-48.
[3] 郭伟, 张忠涛. 胆管内乳头状肿瘤的诊断与治疗. 中华消化外科杂志, 2018, 17:233-236.
[4] 梁霄, 郑俊浩, 高佳琦. 肝内胆管囊腺瘤的诊断与治疗进展. 中华消化外科杂志, 2018, 17:1176-1176.
[5] 何蒙娜, 张璟, 张青,等. 胆管内乳头状黏液性肿瘤的临床表现与影像学特征研究进展. 中国医学科学院学报, 2017, 39:451-455.
[6] 赵永刚, 王明亮, 黄素明,等. 胰腺实性假乳头状肿瘤的CT表现与侵袭性行为的对照研究. 中华放射学杂志, 2020, 54:1089-1094.
[7] 赵黎明, 路涛, 陈光文,等. 肝脏黏液性囊性肿瘤的临床及影像学特点(3例报告并文献复习). 重庆医学, 2019, 48:140-143.
[8] 侯丽艳, 贾如江, 王秀超,等. 胰腺黏液性囊性肿瘤的临床病理特点及良恶性影响因素分析. 临床肝胆病杂志, 2017, 8:116-119.
[9] 吴琛, 冯蕾, 丁雨虹,等. 肝脏黏液性囊性肿瘤与囊肿型肝内胆管乳头状肿瘤CT及MRI表现. 中国医学影像技术, 2019, 35:1356-1360.
[10] 吴辉, 李群兰. MRI常规扫描结合MRCP对胆管内乳头状肿瘤的诊断价值. 西南国防医药, 2018, 28:711-713.
[11] 冯秋霞, 张海龙, 刘畅,等. 胆管内乳头状黏液性肿瘤的影像诊断. 实用放射学杂志, 2019, 35:842-843.
[12] 楼健颖, 粟伟, 魏树梅,等. 胆管导管内乳头状肿瘤的临床特征及诊治分析. 中华外科杂志, 2018, 56:350-354.
[13] Lee S, Kim MJ, Kim S,et al.Intraductal papillary neoplasm of the bile duct: assessment of invasive carcinoma and long-term outcomes using MRI. J Hepatol. 2019, 70:692-699.
[14] 倪丽欣, 楼晓剑, 何萍,等. 肝脏黏液性囊性肿瘤的CT及MRI表现. 中国临床医学影像杂志, 2017, 28:855-857.
[15] 朱中飞, 景国东, 宋彬. 98例胰腺囊性肿瘤影像学特征及诊断分析. 中华胰腺病杂志, 2020, 20:438-442.
[16] 金开璞, 盛若凡, 饶圣祥,等. 采用MRI评价胆管内乳头状肿瘤侵袭性的价值. 中华放射学杂志, 2017, 51:592-596.